Provider Demographics
NPI:1629581384
Name:LOVE, ANTHONY DAVID
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:DAVID
Last Name:LOVE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 ARTILLERY DR
Mailing Address - Street 2:
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043-4304
Mailing Address - Country:US
Mailing Address - Phone:540-664-8356
Mailing Address - Fax:
Practice Address - Street 1:701 LOYOLA AVE STE 106
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70113-1912
Practice Address - Country:US
Practice Address - Phone:504-558-9595
Practice Address - Fax:504-558-9599
Is Sole Proprietor?:No
Enumeration Date:2017-11-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN136229163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult