Provider Demographics
NPI:1740761956
Name:LANDRUM-LOVETT, YAKITTA (NP)
Entity Type:Individual
Prefix:
First Name:YAKITTA
Middle Name:
Last Name:LANDRUM-LOVETT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 GREEN TREE TRL
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38701-8077
Mailing Address - Country:US
Mailing Address - Phone:662-579-6698
Mailing Address - Fax:
Practice Address - Street 1:559A HIGHWAY 1 N
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38701-3136
Practice Address - Country:US
Practice Address - Phone:662-702-5159
Practice Address - Fax:662-702-5167
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-25
Last Update Date:2018-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS902674363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily