Provider Demographics
NPI:1528708674
Name:LOVE, SHIWANNA (RN,BSN)
Entity type:Individual
Prefix:
First Name:SHIWANNA
Middle Name:
Last Name:LOVE
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:SHIWANNA
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3536 HIGHWAY 6 STE 277
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4401
Mailing Address - Country:US
Mailing Address - Phone:713-859-7995
Mailing Address - Fax:888-877-1428
Practice Address - Street 1:15500 VOSS RD STE 1006
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-4601
Practice Address - Country:US
Practice Address - Phone:713-859-7995
Practice Address - Fax:888-877-1428
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2023-05-24
Deactivation Date:2022-10-12
Deactivation Code:
Reactivation Date:2023-04-11
Provider Licenses
StateLicense IDTaxonomies
TX1045123163WC0400X, 251B00000X, 163WG0000X, 163WH0200X, 163WM0705X, 163WP1700X, 163WW0101X, 364SA2100X, 171M00000X
251B00000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No251B00000XAgenciesCase Management
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WP1700XNursing Service ProvidersRegistered NursePerinatal
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care