Provider Demographics
NPI:1790579472
Name:LOVE FAMILY PRACTICE
Entity type:Organization
Organization Name:LOVE FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DYE-LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:606-344-3462
Mailing Address - Street 1:PO BOX 844
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:KY
Mailing Address - Zip Code:40771-0844
Mailing Address - Country:US
Mailing Address - Phone:606-344-3462
Mailing Address - Fax:
Practice Address - Street 1:1805 S MAIN ST STE 5
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-2405
Practice Address - Country:US
Practice Address - Phone:606-344-3462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty