Provider Demographics
NPI:1831848688
Name:LOVELACE, DORIS MAE (CNA)
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:MAE
Last Name:LOVELACE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 GINGER DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-3346
Mailing Address - Country:US
Mailing Address - Phone:434-203-5391
Mailing Address - Fax:
Practice Address - Street 1:219 GINGER DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-3346
Practice Address - Country:US
Practice Address - Phone:434-203-5391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide