Provider Demographics
NPI:1558952309
Name:LOVASZ, MEREDITH M (FNP)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:M
Last Name:LOVASZ
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 1:9099 E LANSING RD STE A
Mailing Address - Street 2:
Mailing Address - City:DURAND
Mailing Address - State:MI
Mailing Address - Zip Code:48429-1083
Mailing Address - Country:US
Mailing Address - Phone:989-288-2651
Mailing Address - Fax:989-288-2087
Practice Address - Street 1:9099 E LANSING RD STE A
Practice Address - Street 2:
Practice Address - City:DURAND
Practice Address - State:MI
Practice Address - Zip Code:48429-1083
Practice Address - Country:US
Practice Address - Phone:989-288-2651
Practice Address - Fax:989-288-2087
Is Sole Proprietor?:No
Enumeration Date:2021-02-02
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704317098363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1558952309Medicaid