Healthcare Provider Details

I. General information

NPI: 1063993251
Provider Name (Legal Business Name): MS. FELICIA LOVE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: FELICIA LOVE RN

II. Dates (important events)

Enumeration Date: 08/24/2018
Last Update Date: 01/24/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 EDDY ST
PROVIDENCE RI
02905-4739
US

IV. Provider business mailing address

511 ACADEMY AVE
PROVIDENCE RI
02908-3401
US

V. Phone/Fax

Practice location:
  • Phone: 401-533-9165
  • Fax:
Mailing address:
  • Phone: 401-536-4281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN65771
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: