Provider Demographics
NPI:1871692616
Name:LOYOLA, GLADYS NMI (PMH-NP)
Entity type:Individual
Prefix:MS
First Name:GLADYS
Middle Name:NMI
Last Name:LOYOLA
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Gender:F
Credentials:PMH-NP
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Other - First Name:
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Mailing Address - Street 1:2502 N DODGE BLVD
Mailing Address - Street 2:STE. 190
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-2671
Mailing Address - Country:US
Mailing Address - Phone:520-618-8692
Mailing Address - Fax:520-206-0575
Practice Address - Street 1:2502 N DODGE BLVD
Practice Address - Street 2:STE. 190
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-2671
Practice Address - Country:US
Practice Address - Phone:520-618-8692
Practice Address - Fax:520-206-0575
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZRN097358363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ691990OtherAHCCCS