Healthcare Provider Details

I. General information

NPI: 1578668208
Provider Name (Legal Business Name): LEANN M. LOVE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 09/02/2020
Certification Date: 09/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

941 SPRING CREEK RD
CHATTANOOGA TN
37412-3909
US

IV. Provider business mailing address

835 WINDY HILL DR
CHATTANOOGA TN
37421-4568
US

V. Phone/Fax

Practice location:
  • Phone: 423-894-7870
  • Fax: 865-539-8008
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN12149
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: