Healthcare Provider Details

I. General information

NPI: 1427006592
Provider Name (Legal Business Name): LACEY J LOVELAND DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5435 RENO CORPORATE DR STE 200
RENO NV
89511-2624
US

IV. Provider business mailing address

PO BOX 845038
LOS ANGELES CA
90084-5038
US

V. Phone/Fax

Practice location:
  • Phone: 775-324-1122
  • Fax:
Mailing address:
  • Phone: 847-627-4920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberDP00433
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number2044
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number6148720002
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: