MEDICARE: ONIKA GIBSON LOVETT FNP

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
1	363LF0000X	Family Nurse Practitioner	235432	AR

General Provider Information

NPI Number	:	1295684439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ONIKA GIBSON LOVETT FNP

Provider Business Mailing Address
First Line	:	PO BOX 986500
Second Line	:	DEPT 3580
City	:	BOSTON
State	:	MA
Zip	:	02298-6500
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1202 NE MCCLAIN RD BLDG 7
Second Line	:
City	:	BENTONVILLE
State	:	AR
Zip	:	72712-3875
Country	:	US
Telephone Number	:	203-901-2493
Fax Number	:	866-497-2991

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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