Healthcare Provider Details

I. General information

NPI: 1700379047
Provider Name (Legal Business Name): LAUREN WILSON LOVE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2018
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8008 E ARAPAHOE CT STE 200
CENTENNIAL CO
80112-6839
US

IV. Provider business mailing address

8008 E ARAPAHOE CT STE 200
CENTENNIAL CO
80112-6839
US

V. Phone/Fax

Practice location:
  • Phone: 303-761-0906
  • Fax: 303-761-0907
Mailing address:
  • Phone: 303-761-0906
  • Fax: 303-761-0907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberDR0072818
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0101268019
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number0101268019
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: