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Individual
SUSAN B LOVELACE
Active
Individual
SUSAN B LOVELACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
2080I0007X
Pediatric Clinical & Laboratory Immunology Physician
R117678
MD
363LP0200X
Pediatric Nurse Practitioner
Primary
R117678
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000290900
—
MD
Enumeration date
07/27/2006
Last updated
06/12/2018
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