Basic Information
| Provider Information | |||||||||
| NPI: | 1841443488 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOVETT | ||||||||
| FirstName: | VANN | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | R.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 668 | ||||||||
| Address2: | |||||||||
| City: | CONRAD | ||||||||
| State: | MT | ||||||||
| PostalCode: | 594250668 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062713211 | ||||||||
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| Practice Location | |||||||||
| Address1: | 805 SUNSET BLVD | ||||||||
| Address2: | |||||||||
| City: | CONRAD | ||||||||
| State: | MT | ||||||||
| PostalCode: | 594251717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062713211 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/28/2008 | ||||||||
| LastUpdateDate: | 10/28/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 98678 | MT | Y | Dietary & Nutritional Service Providers | Dietitian, Registered | 133V00000X | 548 | MT | N | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.