| Doctor Name: | MARY FITZGERALD LOVELIEN |
| NPI Number: | 1063567105 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 2078-023 |
| Business Practice Address: | 1703 N Taylor Dr Sheboygan, WI - 530811933 |
| Business Phone Number: | 9204574438 |
| Business Fax Number: | |
| Mailing Address: | 1703 N Taylor Dr, SHEBOYGAN |
| State: | WI |
| Postal Code: | 530811933 |
| Phone Number: | 9204574438 |
| Fax Number: | |
| NPI Enumeration Date: | 01/25/2007 |
| NPI Last Update Date: | 06/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 2078-023 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |