Provider Demographics
NPI:1164244299
Name:ROSCKOWFF, LOVELY M (RN)
Entity type:Individual
Prefix:
First Name:LOVELY
Middle Name:M
Last Name:ROSCKOWFF
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8554 HUEBNER RD BLDG 3
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-3268
Mailing Address - Country:US
Mailing Address - Phone:210-949-3850
Mailing Address - Fax:
Practice Address - Street 1:8554 HUEBNER RD BLDG 3
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-3268
Practice Address - Country:US
Practice Address - Phone:210-949-3850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71900163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Single Specialty