Provider Demographics
NPI:1346934262
Name:LOVE, JADA KAMIA
Entity Type:Individual
Prefix:
First Name:JADA
Middle Name:KAMIA
Last Name:LOVE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JADA
Other - Middle Name:KAMIA
Other - Last Name:BROOKS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:82 JANE DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14227-1912
Mailing Address - Country:US
Mailing Address - Phone:716-510-3814
Mailing Address - Fax:
Practice Address - Street 1:82 JANE DR
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14227-1912
Practice Address - Country:US
Practice Address - Phone:716-510-3814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY689515163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse