Provider Demographics
NPI:1033462569
Name:LOVETT, PAIGE A (PA-C)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:A
Last Name:LOVETT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 PONAHAWAI ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3027
Mailing Address - Country:US
Mailing Address - Phone:808-933-2982
Mailing Address - Fax:
Practice Address - Street 1:198 PONAHAWAI ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3027
Practice Address - Country:US
Practice Address - Phone:808-933-2982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-22
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5287363AM0700X
HIAMD-529363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical