Individual
KELLY N LOVEJOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1969 W HART RD, BELOIT, WI 53511-2230
(608) 364-5011
Mailing address
1446 N RANDALL AVE, JANESVILLE, WI 53545-1122
(608) 758-7215
(608) 758-3216
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-002425
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00266021
MEDICARE RAILROAD
IL
Enumeration date
07/19/2006
Last updated
11/03/2020
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