MEDICARE: CRYSTAL D LOVETT RN, IBCLC

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	163WM0102X	Maternal Newborn Registered Nurse	83613	WV
2	374J00000X	Doula
3	163WP1700X	Perinatal Registered Nurse	83613	WV
4	163WL0100X	Lactation Consultant (Registered Nurse)	83613	WV
5	163WC1500X	Community Health Registered Nurse	83613	WV
6	163W00000X	Registered Nurse	83613	WV

General Provider Information

NPI Number	:	1568038552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRYSTAL D LOVETT RN, IBCLC

Provider Business Mailing Address
First Line	:	1201 GROSSCUP AVE UNIT 822
Second Line	:
City	:	DUNBAR
State	:	WV
Zip	:	25064-4239
Country	:	US
Telephone Number	:	304-988-5905
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 GROSSCUP AVE UNIT 822
Second Line	:
City	:	DUNBAR
State	:	WV
Zip	:	25064-4239
Country	:	US
Telephone Number	:	304-988-5905
Fax Number	:

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

Provider Enumeration Date	:	06/01/2021
Last Update Date	:	11/07/2025

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