MEDICARE: MRS. CATHY LOVETT

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	174400000X	Specialist	00014	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851447197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CATHY LOVETT

Provider Business Mailing Address
First Line	:	6322 SWAMP FOX HWY W
Second Line	:
City	:	TABOR CITY
State	:	NC
Zip	:	28463-8624
Country	:	US
Telephone Number	:	910-653-9314
Fax Number	:	910-653-9314

Provider Business Practice Location Address
First Line	:	6322 SWAMP FOX HWY W
Second Line	:
City	:	TABOR CITY
State	:	NC
Zip	:	28463-8624
Country	:	US
Telephone Number	:	910-653-9314
Fax Number	:	910-653-9314

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

Provider Enumeration Date	:	01/27/2007
Last Update Date	:	01/08/2008

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