Provider Demographics
NPI:1801350285
Name:LOEBER, BRANDY (PA)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:LOEBER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:
Other - Last Name:1801350285
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1960
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72403-1960
Mailing Address - Country:US
Mailing Address - Phone:870-936-8000
Mailing Address - Fax:870-934-3635
Practice Address - Street 1:4802 E JOHNSON AVE
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-8413
Practice Address - Country:US
Practice Address - Phone:870-936-8000
Practice Address - Fax:870-934-3635
Is Sole Proprietor?:No
Enumeration Date:2019-01-30
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant