Provider Demographics
NPI:1205170693
Name:LOVELL, LINDSAY (ADULT NP)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:
Last Name:LOVELL
Suffix:
Gender:F
Credentials:ADULT NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5400 DUPONT CIRCLE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-2770
Mailing Address - Country:US
Mailing Address - Phone:513-576-7700
Mailing Address - Fax:513-576-1020
Practice Address - Street 1:1507 STATE ROUTE 28
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-8413
Practice Address - Country:US
Practice Address - Phone:513-575-1444
Practice Address - Fax:513-575-1451
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH14094363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0077755Medicaid
OHH169620Medicare PIN