Provider Demographics
NPI:1063731453
Name:LOVINGS, TINA LEA (FNP)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:LEA
Last Name:LOVINGS
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:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4503 OLD MONROE RD
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-5309
Practice Address - Country:US
Practice Address - Phone:980-993-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004747363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7004834Medicaid
NC1063731453Medicaid
SCNP3181Medicaid
NC2595196NMedicare PIN
NC2595196EMedicare PIN
NC2595196GMedicare PIN
NC2595196AMedicare PIN
NC2595196FMedicare PIN
SCNP3181Medicaid
NC2595196KMedicare PIN
NC2595196BMedicare PIN
NC2595196Medicare PIN
NC1063731453Medicaid
NC2595196DMedicare PIN
NC25951961Medicare PIN
NC2595196HMedicare PIN