Provider Demographics
NPI:1437309184
Name:DYE-LOVE, NICHOLE I (APRN)
Entity type:Individual
Prefix:
First Name:NICHOLE
Middle Name:I
Last Name:DYE-LOVE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 S MAIN ST STE 5
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-2405
Mailing Address - Country:US
Mailing Address - Phone:606-215-3228
Mailing Address - Fax:606-215-3603
Practice Address - Street 1:1805 S MAIN ST STE 5
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-2405
Practice Address - Country:US
Practice Address - Phone:606-215-3228
Practice Address - Fax:606-215-3603
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005664363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100059460Medicaid
KYK103160Medicare PIN