Individual provider · NPI-1

Elaine Loth, PNP

Nurse Practitioner, Pediatrics · Stockton, CA

NPI number1164548103
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1164548103
Entity type
Individual (NPI-1)
Name
Elaine Loth
Credential
PNP
Sex
Female
Sole proprietor
No
Enumeration date
Mar 21, 2007
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, PediatricsRN557498CAYes

Practice location

89 W March Ln
Ste #1
Stockton, CA 95207-5721

Phone 209-478-2622

Mailing address

89 W March Ln
Ste #1
Stockton, CA 95207-5721

Phone 209-478-2622

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