Provider Demographics
NPI:1124803671
Name:LOVE, GIOVANNA MARIE (FNP)
Entity type:Individual
Prefix:
First Name:GIOVANNA
Middle Name:MARIE
Last Name:LOVE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:GIOVANNA
Other - Middle Name:MARIE
Other - Last Name:WILDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4724 E WESTCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-7324
Mailing Address - Country:US
Mailing Address - Phone:480-390-8689
Mailing Address - Fax:
Practice Address - Street 1:2929 E. THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-8034
Practice Address - Country:US
Practice Address - Phone:602-470-5560
Practice Address - Fax:602-470-5064
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ294641363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily