Provider Demographics
NPI:1023776242
Name:LOERA, SALOME MARIA (DNP, CNS)
Entity type:Individual
Prefix:DR
First Name:SALOME
Middle Name:MARIA
Last Name:LOERA
Suffix:
Gender:F
Credentials:DNP, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4510 ANDES DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-5325
Mailing Address - Country:US
Mailing Address - Phone:425-614-8735
Mailing Address - Fax:
Practice Address - Street 1:3300 GALLOWS RD # 7.107
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3307
Practice Address - Country:US
Practice Address - Phone:425-614-8735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-05
Last Update Date:2021-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024182638364SA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care