Provider Demographics
NPI:1508333055
Name:LOVERN, NANCY (FNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:LOVERN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 N GALLOWAY AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-2440
Mailing Address - Country:US
Mailing Address - Phone:972-288-9747
Mailing Address - Fax:972-288-2610
Practice Address - Street 1:1320 N GALLOWAY AVE STE 103
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-2440
Practice Address - Country:US
Practice Address - Phone:972-288-9747
Practice Address - Fax:972-288-2610
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139469363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily