Provider Demographics
NPI:1750420196
Name:LOVELL, JENNIFER GAYLE (NP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:GAYLE
Last Name:LOVELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:15024 E LIMESTONE RD STE F
Mailing Address - Street 2:
Mailing Address - City:HARVEST
Mailing Address - State:AL
Mailing Address - Zip Code:35749-7264
Mailing Address - Country:US
Mailing Address - Phone:562-620-5352
Mailing Address - Fax:256-262-0536
Practice Address - Street 1:15024 E LIMESTONE RD STE F
Practice Address - Street 2:
Practice Address - City:HARVEST
Practice Address - State:AL
Practice Address - Zip Code:35749-7264
Practice Address - Country:US
Practice Address - Phone:256-262-0535
Practice Address - Fax:256-262-0536
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-099417363LP0200X
OR200750044NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics