Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 200000527 | NC |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 200000527 | NC |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 200000527 | NC |
NPI | 1376594424 |
---|---|
Provider Name | Rebecca J Love |
First Address | Shelby, NC 28150-2617 |
Second Address | Shelby, NC 28150 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2006 |
Last Update Date | 28/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8912609 | (05) | NC |
H16336 | (02) |