Provider Demographics
NPI:1477390797
Name:LOVELACE, AUNDREA SHEREE (FNP)
Entity type:Individual
Prefix:
First Name:AUNDREA
Middle Name:SHEREE
Last Name:LOVELACE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:AUNDREA
Other - Middle Name:SHEREE
Other - Last Name:HALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:232 MARKET ST OFC 207
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-3339
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:232 MARKET ST OFC 207
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-3339
Practice Address - Country:US
Practice Address - Phone:833-557-8505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-12
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906517363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily