Provider Demographics
NPI:1255593448
Name:LOVELL, KRISTY MARIE
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:MARIE
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 1:731 BEE LICK CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-5249
Mailing Address - Country:US
Mailing Address - Phone:606-308-5455
Mailing Address - Fax:
Practice Address - Street 1:731 BEE LICK CREEK RD
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-5249
Practice Address - Country:US
Practice Address - Phone:606-308-5455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-28
Last Update Date:2008-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator