# FIREFLY MEDICAL GROUP PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962160937
- **Authorized official:** NICOLE LOVAT MD (OWNER PROVIDER)
- **Authorized official phone:** (701) 213-9620

## Contact information

- **Practice address:** 2860 10TH AVE N STE 350, GRAND FORKS, ND 58203-2276
- **Practice address phone:** (701) 213-9620
- **Practice address fax:** (855) 731-1370
- **Mailing address:** 2860 10TH AVE N STE 350, GRAND FORKS, ND 58203-2276

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1835P1200X | Pharmacotherapy Pharmacist | — | NULL | — |
| 1835P1200X | Pharmacotherapy Pharmacist | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/07/2021
- **Last updated:** 01/21/2022