Provider Demographics
NPI:1598163602
Name:LOVELAND, LYNNETTA DEAN (PMHNP, RN)
Entity Type:Individual
Prefix:
First Name:LYNNETTA
Middle Name:DEAN
Last Name:LOVELAND
Suffix:
Gender:F
Credentials:PMHNP, RN
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Other - First Name:
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Mailing Address - Street 1:2865 FOX RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-3176
Mailing Address - Country:US
Mailing Address - Phone:812-603-1264
Mailing Address - Fax:
Practice Address - Street 1:61 LINCOLN ST STE 203
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8264
Practice Address - Country:US
Practice Address - Phone:508-500-6166
Practice Address - Fax:508-500-6167
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-05
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71006221A363LP0808X
MARN2348935363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health