Basic Information
Provider Information
NPI: 1558407742
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LOOSER
FirstName: BARBARA
MiddleName: JEANNE
NamePrefix:  
NameSuffix:  
Credential: CNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3400 OLENTANGY RIVER RD
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432021523
CountryCode: US
TelephoneNumber: 6147545500
FaxNumber: 6144579519
Practice Location
Address1: 3400 OLENTANGY RIVER RD
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432021523
CountryCode: US
TelephoneNumber: 6147545500
FaxNumber: 6147545501
Other Information
ProviderEnumerationDate: 01/29/2007
LastUpdateDate: 03/10/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/10/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XNP07906OHY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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