Provider Demographics
NPI:1912398397
Name:LOOMIS, CLAIRE ALLEEN (PA-C)
Entity type:Individual
Prefix:MS
First Name:CLAIRE
Middle Name:ALLEEN
Last Name:LOOMIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1155 MILL STREET
Mailing Address - Street 2:MS M-14
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1576
Mailing Address - Country:US
Mailing Address - Phone:775-982-5262
Mailing Address - Fax:775-982-8046
Practice Address - Street 1:745 W MOANA LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-4991
Practice Address - Country:US
Practice Address - Phone:775-982-1000
Practice Address - Fax:775-982-8046
Is Sole Proprietor?:No
Enumeration Date:2015-02-06
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA57658363A00000X
NVPA2329363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA57658OtherSTATE LICENSE
HIAMD596OtherSTATE LICENSE