Provider Demographics
NPI:1508013624
Name:LOVELAND, KATHRYN MILLER (NP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MILLER
Last Name:LOVELAND
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 1:1 INDEPENDENCE PT STE 212
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4536
Mailing Address - Country:US
Mailing Address - Phone:864-797-6308
Mailing Address - Fax:
Practice Address - Street 1:201 E BROAD ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29306-3233
Practice Address - Country:US
Practice Address - Phone:864-707-2135
Practice Address - Fax:864-707-2136
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024096329363LP0200X
PASP016439363LP0200X
SC22868363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics