Provider Demographics
NPI:1083505515
Name:LOVGREN, MASON THOMAS
Entity type:Individual
Prefix:
First Name:MASON
Middle Name:THOMAS
Last Name:LOVGREN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 S 158TH CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2523
Mailing Address - Country:US
Mailing Address - Phone:402-740-0120
Mailing Address - Fax:
Practice Address - Street 1:16512 POPPLETON AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-1356
Practice Address - Country:US
Practice Address - Phone:402-740-0120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-12
Last Update Date:2025-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No372500000XNursing Service Related ProvidersChore Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant