Provider Demographics
NPI:1003835794
Name:LOVE, TIFFANY A (CNP)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:A
Last Name:LOVE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3605 WARRENSVILLE CENTER RD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5203
Mailing Address - Country:US
Mailing Address - Phone:216-286-6295
Mailing Address - Fax:216-286-6341
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN281260163WC3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC3500XNursing Service ProvidersRegistered NurseCardiac Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH7447787OtherAETNA
OH750859OtherBUCKEYE
OH2683869Medicaid
OHP00358810OtherRAILROAD MEDICARE
OH000000503618OtherANTHEM
OH000000221314OtherUNISON
OH363780OtherWELLCARE
OHLONP20722Medicare PIN
OH750859OtherBUCKEYE
OH7447787OtherAETNA