Provider Demographics
NPI:1659054237
Name:JOSIAH-TETTEH, LOVE
Entity Type:Individual
Prefix:
First Name:LOVE
Middle Name:
Last Name:JOSIAH-TETTEH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3418 DROPSEED DR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-7409
Mailing Address - Country:US
Mailing Address - Phone:804-971-9447
Mailing Address - Fax:
Practice Address - Street 1:6001 MCCRIMMON PKWY STE 200A
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-8127
Practice Address - Country:US
Practice Address - Phone:919-342-5383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCNM08817367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife