Provider Demographics
NPI:1578668208
Name:LOVE, LEANN M (NP)
Entity Type:Individual
Prefix:MS
First Name:LEANN
Middle Name:M
Last Name:LOVE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:835 WINDY HILL DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-4568
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:941 SPRING CREEK RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37412-3909
Practice Address - Country:US
Practice Address - Phone:423-894-7870
Practice Address - Fax:865-539-8008
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN12149363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNPENDINGOtherBCBS OF TENNESSEE
TNPENDINGOtherBCBS OF TENNESSEE
TNPENDINGMedicare ID - Type Unspecified