MEDICARE: HEATHER LOVEJOY FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	354938	NY

General Provider Information

NPI Number	:	1578396321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER LOVEJOY FNP-BC

Provider Business Mailing Address
First Line	:	59 PINEWOOD KNL
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14624-4763
Country	:	US
Telephone Number	:	585-315-2590
Fax Number	:

Provider Business Practice Location Address
First Line	:	2232 LYELL AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14606-5720
Country	:	US
Telephone Number	:	585-417-4125
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2024
Last Update Date	:	08/26/2024

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Directions to “ HEATHER LOVEJOY FNP-BC” Practice Location

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