Provider Demographics
NPI:1265871040
Name:LOVE-SCOTT, AMARAVA D (LPN)
Entity type:Individual
Prefix:MS
First Name:AMARAVA
Middle Name:D
Last Name:LOVE-SCOTT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5088 SPAULDING CT
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-1843
Mailing Address - Country:US
Mailing Address - Phone:440-308-2878
Mailing Address - Fax:
Practice Address - Street 1:5088 SPAULDING CT
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-1843
Practice Address - Country:US
Practice Address - Phone:440-308-2878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH109727164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse