Provider Demographics
NPI:1104305341
Name:LOVELL, PAMELA F (LVN)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:F
Last Name:LOVELL
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 COUNTY ROAD 403
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:TX
Mailing Address - Zip Code:76531-3012
Mailing Address - Country:US
Mailing Address - Phone:501-317-1743
Mailing Address - Fax:
Practice Address - Street 1:656 COUNTY ROAD 4930
Practice Address - Street 2:
Practice Address - City:KEMPNER
Practice Address - State:TX
Practice Address - Zip Code:76539-8052
Practice Address - Country:US
Practice Address - Phone:501-317-1743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX319088164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse