Provider Demographics
NPI:1073794715
Name:LOVELESS, MEREDITH LEE (LPN)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:LEE
Last Name:LOVELESS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 KAY CIR
Mailing Address - Street 2:
Mailing Address - City:CANASTOTA
Mailing Address - State:NY
Mailing Address - Zip Code:13032-1253
Mailing Address - Country:US
Mailing Address - Phone:315-436-3849
Mailing Address - Fax:
Practice Address - Street 1:2 TERRITORY RD
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-9304
Practice Address - Country:US
Practice Address - Phone:315-829-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-23
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY287003164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse