Provider Demographics
NPI:1497240725
Name:LOEFFLER, AMANDA (CNM)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:LOEFFLER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4470 KNOX LN
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38506-6547
Mailing Address - Country:US
Mailing Address - Phone:931-349-7708
Mailing Address - Fax:
Practice Address - Street 1:820 N THOMPSON LN STE 1A
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-4340
Practice Address - Country:US
Practice Address - Phone:615-494-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1033057367A00000X
TN24358367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife