Provider Demographics
NPI:1447268750
Name:LOVELL, LARA CHRISTIAN (FNP)
Entity type:Individual
Prefix:MRS
First Name:LARA
Middle Name:CHRISTIAN
Last Name:LOVELL
Suffix:
Gender:F
Credentials:FNP
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Mailing Address - Street 1:620 N KIMBALL AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092
Mailing Address - Country:US
Mailing Address - Phone:817-328-8376
Mailing Address - Fax:817-328-8379
Practice Address - Street 1:1207 ARISTA DRIVE
Practice Address - Street 2:SUITE 103
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032
Practice Address - Country:US
Practice Address - Phone:469-402-1877
Practice Address - Fax:469-402-1969
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2016-08-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXAP112809363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX697051OtherFNP-C
TXTX 697051OtherREGISTERED NURSE BNE