Provider Demographics
NPI:1497298079
Name:DUNCAN, LOVESTER (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MISS
First Name:LOVESTER
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:MISS
Other - First Name:LOVESTER
Other - Middle Name:
Other - Last Name:DUNCAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:22 GARLAND AVE # 1
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-7020
Mailing Address - Country:US
Mailing Address - Phone:857-233-8557
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL FOR BEHAVIORAL MEDICINE
Practice Address - Street 2:100 CENTURY DRIVE
Practice Address - City:WORCERSTER
Practice Address - State:MA
Practice Address - Zip Code:01606
Practice Address - Country:US
Practice Address - Phone:774-366-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-30
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2292549163W00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse