Provider Demographics
NPI:1487191706
Name:LOVE, RONI RAE (BS)
Entity Type:Individual
Prefix:MISS
First Name:RONI
Middle Name:RAE
Last Name:LOVE
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 BEASLEY ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-4266
Mailing Address - Country:US
Mailing Address - Phone:406-598-1437
Mailing Address - Fax:
Practice Address - Street 1:900 BEASLEY ST
Practice Address - Street 2:SUITE 120
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-4266
Practice Address - Country:US
Practice Address - Phone:406-598-1437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator