Healthcare Provider Details

I. General information

NPI: 1083386585
Provider Name (Legal Business Name): MASSAHZOE LOVETT CNS, MSCN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2021
Last Update Date: 02/10/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3617 SPRATLING WAY
NORTH CHESTERFIELD VA
23237-1954
US

IV. Provider business mailing address

3617 SPRATLING WAY
NORTH CHESTERFIELD VA
23237-1954
US

V. Phone/Fax

Practice location:
  • Phone: 804-482-1182
  • Fax:
Mailing address:
  • Phone: 804-482-1182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number18189
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number18189
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: