MEDICARE: NANCE ANN LOVELACE D.O.

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	207Q00000X	Family Medicine Physician	0102201255	VA

General Provider Information

NPI Number	:	1447216163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCE ANN LOVELACE D.O.

Provider Business Mailing Address
First Line	:	9166 N CONGRESS ST
Second Line	:
City	:	NEW MARKET
State	:	VA
Zip	:	22844-9422
Country	:	US
Telephone Number	:	540-459-1340
Fax Number	:	540-459-1349

Provider Business Practice Location Address
First Line	:	9166 N CONGRESS ST
Second Line	:
City	:	NEW MARKET
State	:	VA
Zip	:	22844-9422
Country	:	US
Telephone Number	:	540-459-1340
Fax Number	:	540-459-1349

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

Provider Enumeration Date	:	04/21/2006
Last Update Date	:	04/05/2021

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