Provider Demographics
NPI:1457949372
Name:LOVE, SHARON MARIE (LVN)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:MARIE
Last Name:LOVE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:JUNCTION
Mailing Address - State:TX
Mailing Address - Zip Code:76849-3626
Mailing Address - Country:US
Mailing Address - Phone:228-547-3678
Mailing Address - Fax:
Practice Address - Street 1:210 CHERRY ST
Practice Address - Street 2:
Practice Address - City:JUNCTION
Practice Address - State:TX
Practice Address - Zip Code:76849-3626
Practice Address - Country:US
Practice Address - Phone:228-547-3678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171097164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse