Provider Demographics
NPI:1922719863
Name:MCDONALD-LOVELL, DORRETT (NP)
Entity Type:Individual
Prefix:MRS
First Name:DORRETT
Middle Name:
Last Name:MCDONALD-LOVELL
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 1:267 GROUPER CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-4838
Mailing Address - Country:US
Mailing Address - Phone:407-218-2736
Mailing Address - Fax:
Practice Address - Street 1:267 GROUPER CT
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-4838
Practice Address - Country:US
Practice Address - Phone:407-218-2736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-12
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11024165363LP0808X
FLRN2915682163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11024165OtherNURSE PRACTIONER
FLRN2915682OtherREGISTERED NURSE