Provider Demographics
NPI:1427538024
Name:LOVATO, CHRISTELLA ANNE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTELLA
Middle Name:ANNE
Last Name:LOVATO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:STATE HWY 121
Mailing Address - City:HOLMAN
Mailing Address - State:NM
Mailing Address - Zip Code:87723
Mailing Address - Country:US
Mailing Address - Phone:505-917-9568
Mailing Address - Fax:
Practice Address - Street 1:1202 N RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:ESPANOLA
Practice Address - State:NM
Practice Address - Zip Code:87532-2976
Practice Address - Country:US
Practice Address - Phone:505-367-3594
Practice Address - Fax:505-367-0805
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00008953183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist