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NPI Code Detail

MEDICARE: TRACIE LOVETT

MEDICARE: TRACIE LOVETT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP141746TX

General Provider Information

NPI Number : 1134558125
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACIE LOVETT
Provider Business Mailing Address
First Line : 30 MARYLAND PLZ FL 3
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63108-1556
Country : US
Telephone Number : 314-720-5858
Fax Number :
Provider Business Practice Location Address
First Line : 30 MARYLAND PLZ FL 3
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63108-1556
Country : US
Telephone Number : 815-517-8653
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2013
Last Update Date : 04/23/2025

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Directions to “ TRACIE LOVETT ” Practice Location

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