MEDICARE: ELIZABETH SLOAN LOVETT CRNP

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	363L00000X	Nurse Practitioner	1-143490	AL

General Provider Information

NPI Number	:	1962983171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH SLOAN LOVETT CRNP

Provider Business Mailing Address
First Line	:	5367 HOLLEY LN
Second Line	:
City	:	ORANGE BEACH
State	:	AL
Zip	:	36561-3675
Country	:	US
Telephone Number	:	251-609-1539
Fax Number	:

Provider Business Practice Location Address
First Line	:	25775 PERDIDO BEACH BLVD STE E
Second Line	:
City	:	ORANGE BEACH
State	:	AL
Zip	:	36561-6603
Country	:	US
Telephone Number	:	251-974-3004
Fax Number	:

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

Provider Enumeration Date	:	08/25/2018
Last Update Date	:	08/25/2018

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