Provider Demographics
NPI:1063533941
Name:LOVEGREN, ANN A (FNP)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:A
Last Name:LOVEGREN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-3617
Mailing Address - Country:US
Mailing Address - Phone:866-389-2727
Mailing Address - Fax:207-767-1726
Practice Address - Street 1:51 MARKET ST
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-3617
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:207-767-1726
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP081413363LF0000X
MECNP81413363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MENP227001Medicare PIN