Active NPI
Avis Colleen Love, LPN
- Licensed Practical Nurse
- Inkster, MI
National Provider Identifier
1225417587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 4703053762
- Practice address
- 1291 Woodland Dr
Inkster, MI 48141-1741 - Phone
- (313) 565-7831
- Fax
- (313) 565-7831
- NPI assigned
- May 20, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 4703053762 | MI | Primary |
Addresses
Primary practice location
1291 Woodland Dr
Inkster, MI 48141-1741
Mailing address
1291 Woodland Dr
Inkster, MI 48141-1741
Phone (313) 565-7831
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16 | Other | MI | LPN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4703053762 | MI | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432080000000",
"number": "1225417587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1291 WOODLAND DR",
"city": "INKSTER",
"state": "MI",
"postal_code": "481411741",
"telephone_number": "313-565-7831",
"fax_number": "313-565-7831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1291 WOODLAND DR",
"city": "INKSTER",
"state": "MI",
"postal_code": "481411741",
"telephone_number": "313-565-7831",
"fax_number": "313-565-7831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOVE",
"first_name": "AVIS",
"middle_name": "COLLEEN",
"name_prefix": "Ms.",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-20",
"last_updated": "2015-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "MI",
"license": "4703053762",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPN",
"identifier": "16",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Inkster, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.