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Individual
MRS. JESSICA LOVE
Active
Individual
MRS. JESSICA LOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
75581
KS
363LF0000X
Family Nurse Practitioner
53-75581-081
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068002156
MEDICARE PTAN
KS
05
—
200862460A
—
KS
Enumeration date
01/25/2012
Last updated
03/31/2017
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