Provider Demographics
NPI:1760710289
Name:LOVAN, CHARITY (RN)
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:
Last Name:LOVAN
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 1:2175 LEXINGTON BLVD
Mailing Address - Street 2:BUILDING #2
Mailing Address - City:WASHINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52353-9108
Mailing Address - Country:US
Mailing Address - Phone:319-653-6161
Mailing Address - Fax:888-243-3455
Practice Address - Street 1:2175 LEXINGTON BLVD
Practice Address - Street 2:BUILDING #2
Practice Address - City:WASHINGTON
Practice Address - State:IA
Practice Address - Zip Code:52353-9108
Practice Address - Country:US
Practice Address - Phone:319-653-6161
Practice Address - Fax:888-243-3455
Is Sole Proprietor?:No
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA106456163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse