Provider Demographics
NPI:1194001727
Name:LOVE, ARECIA PATRICE (NURSING ASSISTANT)
Entity Type:Individual
Prefix:MS
First Name:ARECIA
Middle Name:PATRICE
Last Name:LOVE
Suffix:
Gender:F
Credentials:NURSING ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19207 PACKARD ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48234-3197
Mailing Address - Country:US
Mailing Address - Phone:586-480-1587
Mailing Address - Fax:877-948-4348
Practice Address - Street 1:2445 DUNN AVE APT 1215
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-6903
Practice Address - Country:US
Practice Address - Phone:586-443-3334
Practice Address - Fax:877-948-4348
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI236805820793376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide