Provider Demographics
NPI:1801054655
Name:LOZMANOXMAN, REBECCA LAUREN (CPNP)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:LAUREN
Last Name:LOZMANOXMAN
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 JOHN STARK HWY
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:NH
Mailing Address - Zip Code:03773-1807
Mailing Address - Country:US
Mailing Address - Phone:603-863-4100
Mailing Address - Fax:603-863-8800
Practice Address - Street 1:11 JOHN STARK HWY
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:NH
Practice Address - Zip Code:03773-1807
Practice Address - Country:US
Practice Address - Phone:603-863-4100
Practice Address - Fax:603-863-8800
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR174802363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD018028900Medicaid