Individual
JESSICA JEAN LOVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
406 N SPRING ST, MCMINNVILLE, TN 37110-2134
(931) 507-1212
Mailing address
PO BOX 640, MCMINNVILLE, TN 37111-0640
(931) 507-1212
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
80024
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80024
LPN
TN
Enumeration date
08/01/2013
Last updated
08/01/2013
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