Provider Demographics
NPI:1568900207
Name:HOUSTON, LOVETTA ALECIA (GNA)
Entity Type:Individual
Prefix:
First Name:LOVETTA
Middle Name:ALECIA
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:GNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2413 ARUNAH AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21216-4824
Mailing Address - Country:US
Mailing Address - Phone:410-314-8463
Mailing Address - Fax:
Practice Address - Street 1:2413 ARUNAH AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21216-4824
Practice Address - Country:US
Practice Address - Phone:410-314-8463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-02
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDHCS800393251J00000X
171W00000X, 3336M0002X, 372500000X, 372600000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No171W00000XOther Service ProvidersContractor
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide