Provider Demographics
NPI:1821773466
Name:LOVELL, ANGELA YVONNE
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:YVONNE
Last Name:LOVELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7457 HIGHWAY 41A
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37032-6607
Mailing Address - Country:US
Mailing Address - Phone:931-980-5628
Mailing Address - Fax:
Practice Address - Street 1:7457 HIGHWAY 41A
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TN
Practice Address - Zip Code:37032-6607
Practice Address - Country:US
Practice Address - Phone:931-980-5628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-20
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN165914163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice