Provider Demographics
NPI:1821417023
Name:LOVELL, LASHANNA SHANICE (MD)
Entity Type:Individual
Prefix:
First Name:LASHANNA
Middle Name:SHANICE
Last Name:LOVELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 N SHELBY ST
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46403-1446
Mailing Address - Country:US
Mailing Address - Phone:219-938-0921
Mailing Address - Fax:219-938-0923
Practice Address - Street 1:1015 N SHELBY ST
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46403-1446
Practice Address - Country:US
Practice Address - Phone:219-938-0921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01078494A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics