Provider Demographics
NPI:1083461230
Name:LOVELL, MARY HELEN (RN)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:HELEN
Last Name:LOVELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 POMFRET ST
Mailing Address - Street 2:
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132-1809
Mailing Address - Country:US
Mailing Address - Phone:617-549-4448
Mailing Address - Fax:
Practice Address - Street 1:25 POMFRET ST
Practice Address - Street 2:
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-1809
Practice Address - Country:US
Practice Address - Phone:617-549-4448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA144881163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse