Provider Demographics
NPI:1104623594
Name:VITTETOE, LORI LOVEDAY
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:LOVEDAY
Last Name:VITTETOE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 GATE LN STE 201
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-3518
Mailing Address - Country:US
Mailing Address - Phone:865-313-3409
Mailing Address - Fax:
Practice Address - Street 1:705 GATE LN STE 201
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-3518
Practice Address - Country:US
Practice Address - Phone:865-313-3409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38298363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily