Doctor Name: | BETH L LOVE |
NPI Number: | 1659675775 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 28142197A |
Business Practice Address: | Highway 264 Milepost 388 Polacca, AZ - 860424000 |
Business Phone Number: | 9287376053 |
Business Fax Number: | 9287376200 |
Mailing Address: | Po Box 4000, POLACCA |
State: | AZ |
Postal Code: | 860424000 |
Phone Number: | 9287376053 |
Fax Number: | 9287376200 |
NPI Enumeration Date: | 01/04/2011 |
NPI Last Update Date: | 01/04/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WC1500X |
License Number: | 28142197A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Community Health |
Taxonomy Definition: |