Provider Demographics
NPI:1265082945
Name:LOVETT, HEATHER ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ELIZABETH
Last Name:LOVETT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SW 89TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-8534
Mailing Address - Country:US
Mailing Address - Phone:405-455-3322
Mailing Address - Fax:405-606-4330
Practice Address - Street 1:8 SW 89TH ST STE 100
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-8534
Practice Address - Country:US
Practice Address - Phone:405-455-3322
Practice Address - Fax:405-606-4330
Is Sole Proprietor?:No
Enumeration Date:2019-09-16
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI2998363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant