Individual
NIKKI TENNILLE LOVE-BRAITHWAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
PO BOX 17370, 6420, SAINT PAUL, MN 55117-0370
(612) 987-4301
Mailing address
PO BOX 17370, 6420, SAINT PAUL, MN 55117-0370
(612) 987-4301
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1879599
MN
363LG0600X
Gerontology Nurse Practitioner
Primary
13872
MN
Other
Enumeration date
01/12/2026
Last updated
04/15/2026
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