Provider Demographics
NPI:1912295031
Name:LOFLEY, KATHLEEN M (RN, BSN)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:LOFLEY
Suffix:
Gender:F
Credentials:RN, BSN
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1920 W 250 N
Mailing Address - Street 2:STE 17
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84404-9271
Mailing Address - Country:US
Mailing Address - Phone:801-689-3490
Mailing Address - Fax:385-244-1286
Practice Address - Street 1:2727 N WASHINGTON BLVD
Practice Address - Street 2:SUITE 305
Practice Address - City:NORTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84414-2241
Practice Address - Country:US
Practice Address - Phone:801-358-8843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-11
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT7752143-3102163WC0400X, 163WP2201X, 163WU0100X
UT7752143-4405363LW0102X
UT7752143-4402367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No163WU0100XNursing Service ProvidersRegistered NurseUrology
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT7752143-4405OtherSTATE OF UTAH APRN- WHNP-BC
UT7752143-4402OtherCERTIFIED NURSE MIDWIFE