Healthcare Provider Details

I. General information

NPI: 1033881446
Provider Name (Legal Business Name): KATIE LOVETT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2021
Last Update Date: 10/04/2021
Certification Date: 10/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3407 WILKENS AVE STE 240
BALTIMORE MD
21229-5222
US

IV. Provider business mailing address

11350 MCCORMICK RD EXECUTIVE PLAZA 1, STE. 501
HUNT VALLEY MD
21031
US

V. Phone/Fax

Practice location:
  • Phone: 410-644-8500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR220090
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: