Individual
CANDISE ANN LOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1231 PINE GROVE AVE, STE 2F, PORT HURON, MI 48060-3500
(810) 982-5200
Mailing address
1231 PINE GROVE AVE, STE 2F, PORT HURON, MI 48060-3500
(810) 982-5200
Taxonomy
Speciality
Code
Description
License number
State
163WX0200X
Oncology Registered Nurse
4704261280
MI
363LA2100X
Acute Care Nurse Practitioner
Primary
4704261280
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801102371
—
MI
Enumeration date
08/23/2010
Last updated
08/01/2016
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