Healthcare Provider Details

I. General information

NPI: 1427862457
Provider Name (Legal Business Name): AMBER JENEA LOVE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W GROVE ST
EL DORADO AR
71730-4416
US

IV. Provider business mailing address

107 STONEY CREEK DR
EL DORADO AR
71730-6076
US

V. Phone/Fax

Practice location:
  • Phone: 870-863-2000
  • Fax:
Mailing address:
  • Phone: 870-918-9629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberR078463
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberR078463
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code163WF0300X
TaxonomyFlight Registered Nurse
License NumberR078463
License Number StateAR
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number230779
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: