Provider Demographics
NPI:1821306093
Name:LOVERING, JACQUELIN M (RN-C)
Entity Type:Individual
Prefix:MS
First Name:JACQUELIN
Middle Name:M
Last Name:LOVERING
Suffix:
Gender:F
Credentials:RN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:ME
Mailing Address - Zip Code:04352-3837
Mailing Address - Country:US
Mailing Address - Phone:207-242-7929
Mailing Address - Fax:
Practice Address - Street 1:730 PLAINS RD
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:ME
Practice Address - Zip Code:04352-3837
Practice Address - Country:US
Practice Address - Phone:207-242-7929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER037162163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent