Provider Demographics
NPI:1053695767
Name:LOVEJOY, ROBERT D (CRNA)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:D
Last Name:LOVEJOY
Suffix:
Gender:
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 COUNTRY WAY
Mailing Address - Street 2:
Mailing Address - City:TORNADO
Mailing Address - State:WV
Mailing Address - Zip Code:25202-9734
Mailing Address - Country:US
Mailing Address - Phone:304-444-1278
Mailing Address - Fax:
Practice Address - Street 1:84 BROOKSHIRE LN
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-6765
Practice Address - Country:US
Practice Address - Phone:304-255-2724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV111221363LP0808X
WVAPRN68169-CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health