Provider Demographics
NPI:1700554219
Name:SCHROUDER, LOVE DIVINE
Entity Type:Individual
Prefix:MS
First Name:LOVE
Middle Name:DIVINE
Last Name:SCHROUDER
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 1:131 HATTAWAY DR
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-5229
Mailing Address - Country:US
Mailing Address - Phone:321-332-3366
Mailing Address - Fax:
Practice Address - Street 1:131 HATTAWAY DR
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-5229
Practice Address - Country:US
Practice Address - Phone:321-332-3366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoula
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty