Healthcare Provider Details

I. General information

NPI: 1639780414
Provider Name (Legal Business Name): NICOLETTE R LOVITT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2020
Last Update Date: 07/04/2025
Certification Date: 07/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 NORTH ST
ADAIR IA
50002-1126
US

IV. Provider business mailing address

925 STAGECOACH RD
COON RAPIDS IA
50058-1045
US

V. Phone/Fax

Practice location:
  • Phone: 641-390-6005
  • Fax:
Mailing address:
  • Phone: 712-304-8077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number113265
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA160353
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: