Provider Demographics
NPI:1750926689
Name:OLOKO-NELSON, LOVAN VANCLIN (APN)
Entity type:Individual
Prefix:
First Name:LOVAN
Middle Name:VANCLIN
Last Name:OLOKO-NELSON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 PATERSON AVE
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07502-1706
Mailing Address - Country:US
Mailing Address - Phone:973-202-9466
Mailing Address - Fax:
Practice Address - Street 1:1300 MAIN AVE STE 1B
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2266
Practice Address - Country:US
Practice Address - Phone:973-689-6700
Practice Address - Fax:973-689-6582
Is Sole Proprietor?:No
Enumeration Date:2019-11-14
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00968800363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health