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NPI Code Detail

MEDICARE: DR. NICHOLE LOVE-GROVE D.O.

MEDICARE: DR. NICHOLE LOVE-GROVE D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician323810LA
2207R00000XInternal Medicine Physician27936MS

General Provider Information

NPI Number : 1114466232
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICHOLE LOVE-GROVE D.O.
Provider Business Mailing Address
First Line : 307 LAKESHORE VLG E
Second Line :
City : SLIDELL
State : LA
Zip : 70461-5608
Country : US
Telephone Number : 504-931-5188
Fax Number :
Provider Business Practice Location Address
First Line : 330 OAK HARBOR BLVD STE B
Second Line :
City : SLIDELL
State : LA
Zip : 70458-5703
Country : US
Telephone Number : 504-931-5188
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2017
Last Update Date : 09/06/2024

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Directions to “ DR. NICHOLE LOVE-GROVE D.O.” Practice Location

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