Provider Demographics
NPI:1376751719
Name:LOVELESS, DONNA LEE (LPN)
Entity Type:Individual
Prefix:MS
First Name:DONNA
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 1:904 RUE MAX ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32507-2215
Mailing Address - Country:US
Mailing Address - Phone:850-435-9354
Mailing Address - Fax:
Practice Address - Street 1:904 RUE MAX ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32507-2215
Practice Address - Country:US
Practice Address - Phone:850-435-9354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAP22886164W00000X
FLPN5168365164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse