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General NPI Number Information
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NPI Number | 1740595206
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Entity Type | Individual
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Provider Name | AMY ELIZABETH LOVELL PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/09/2010
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Last Update Date | 01/12/2021
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Provider Practice Location Address
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Address Line | 5249 E TERRACE DR
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City | MADISON
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State | WI
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Zip | 53718
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Country | US
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Telephone | 608-263-9550
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Fax | 608-263-0135
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Provider Business Mailing Address
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Address Line | 9322 COBALT ST
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City | MIDDLETON
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State | WI
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Zip | 53562-5601
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Country | US
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Telephone | 262-949-5115
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 3523
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License Number State | WI
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