Healthcare Provider Details

I. General information

NPI: 1538712609
Provider Name (Legal Business Name): ELISA CATHERINE LOVE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2019
Last Update Date: 07/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

573 MERRIMON AVE
ASHEVILLE NC
28804-3490
US

IV. Provider business mailing address

573 MERRIMON AVE
ASHEVILLE NC
28804-3490
US

V. Phone/Fax

Practice location:
  • Phone: 828-251-1478
  • Fax: 828-251-5227
Mailing address:
  • Phone: 828-251-1478
  • Fax: 828-251-5227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number302784
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: