Provider Demographics
NPI:1265155378
Name:SHIWANNA LOVE, RN, BSN
Entity type:Organization
Organization Name:SHIWANNA LOVE, RN, BSN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHIWANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:713-859-7995
Mailing Address - Street 1:PO BOX 16054
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-6054
Mailing Address - Country:US
Mailing Address - Phone:713-859-7995
Mailing Address - Fax:
Practice Address - Street 1:2222 SETTLERS WAY BLVD APT 1627
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5258
Practice Address - Country:US
Practice Address - Phone:713-859-7995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management