Provider Demographics
NPI:1598021735
Name:LOVELL, FEDELIA (RN)
Entity Type:Individual
Prefix:
First Name:FEDELIA
Middle Name:
Last Name:LOVELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 NASSAU PKWY
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-7341
Mailing Address - Country:US
Mailing Address - Phone:516-489-2392
Mailing Address - Fax:
Practice Address - Street 1:45 NASSAU PKWY
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-7341
Practice Address - Country:US
Practice Address - Phone:516-489-2392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY284616163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse