MEDICARE: DR. LAUREN WILSON LOVE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	208D00000X	General Practice Physician	0101268019	VA
3	207N00000X	Dermatology Physician	0101268019	VA

General Provider Information

NPI Number	:	1700379047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAUREN WILSON LOVE MD

Provider Business Mailing Address
First Line	:	8008 E ARAPAHOE CT STE 200
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80112-6839
Country	:	US
Telephone Number	:	303-761-0906
Fax Number	:	303-761-0907

Provider Business Practice Location Address
First Line	:	1650 COCHRANE CIR
Second Line	:
City	:	FORT CARSON
State	:	CO
Zip	:	80913-4613
Country	:	US
Telephone Number	:	719-526-7670
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2018
Last Update Date	:	04/07/2026

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