Provider Demographics
NPI:1760042428
Name:LOVE, YVIKA ARRE (FNP-C)
Entity Type:Individual
Prefix:
First Name:YVIKA
Middle Name:ARRE
Last Name:LOVE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 305
Mailing Address - Street 2:
Mailing Address - City:KINGSLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31548-0305
Mailing Address - Country:US
Mailing Address - Phone:904-235-2374
Mailing Address - Fax:
Practice Address - Street 1:113 POMEGRANATE ST
Practice Address - Street 2:
Practice Address - City:KINGSLAND
Practice Address - State:GA
Practice Address - Zip Code:31548-3267
Practice Address - Country:US
Practice Address - Phone:904-235-2374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-15
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAF05190074363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily