Provider Demographics
NPI:1053376442
Name:LOHUIS, NANCY ANN (MD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:ANN
Last Name:LOHUIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 12TH STREET
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-2352
Mailing Address - Country:US
Mailing Address - Phone:304-487-7936
Mailing Address - Fax:304-431-5152
Practice Address - Street 1:118 12TH STREET
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-2352
Practice Address - Country:US
Practice Address - Phone:304-487-7936
Practice Address - Fax:304-431-5152
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV16854207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0053383000Medicaid
WV2229AMedicare PIN
WVF09306901Medicare ID - Type Unspecified
WV0053383000Medicaid