Healthcare Provider Details

I. General information

NPI: 1447216163
Provider Name (Legal Business Name): NANCE ANN LOVELACE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 04/05/2021
Certification Date: 04/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9166 N CONGRESS ST
NEW MARKET VA
22844-9422
US

IV. Provider business mailing address

9166 N CONGRESS ST
NEW MARKET VA
22844-9422
US

V. Phone/Fax

Practice location:
  • Phone: 540-459-1340
  • Fax: 540-459-1349
Mailing address:
  • Phone: 540-459-1340
  • Fax: 540-459-1349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0102201255
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: