Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 20040533A | IN |
N | 103TC0700X | Clinical Psychologist | 20040533A | IN |
Y | 103TH0100X | Health Service | 20040533A | IN |
NPI | 1306845516 |
---|---|
Provider Name | Dr. Ann M Lovko |
First Address | Indianapolis, IN 46250-2890 |
Second Address | Indianapolis, IN 46250-2040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2005 |
Last Update Date | 01/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000828660 | ANTHEM BCBS (01) | IN |
100353020 | (05) | IN |
R33865 | (02) | IN |