Provider Demographics
NPI:1427562875
Name:LOVEJOY, NICOLE MARIE (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:MARIE
Last Name:LOVEJOY
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5755 OAK RUN LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-1948
Mailing Address - Country:US
Mailing Address - Phone:802-734-8265
Mailing Address - Fax:
Practice Address - Street 1:28 WESTHAMPTON WAY
Practice Address - Street 2:ROBINS CENTER RM 163
Practice Address - City:UNIVERSITY OF RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23173
Practice Address - Country:US
Practice Address - Phone:804-287-6841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260017582255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer