Healthcare Provider Details

I. General information

NPI: 1598163602
Provider Name (Legal Business Name): LYNNETTA DEAN LOVELAND PMHNP, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2014
Last Update Date: 03/10/2021
Certification Date: 03/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 LINCOLN ST STE 203
FRAMINGHAM MA
01702-8264
US

IV. Provider business mailing address

2865 FOX RIDGE CIR
COLUMBUS IN
47203-3176
US

V. Phone/Fax

Practice location:
  • Phone: 508-500-6166
  • Fax: 508-500-6167
Mailing address:
  • Phone: 812-603-1264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number71006221A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2348935
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: