Healthcare Provider Details

I. General information

NPI: 1013680180
Provider Name (Legal Business Name): JODIE LOVE R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2021
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 E 19TH AVE
DENVER CO
80218-1114
US

IV. Provider business mailing address

1975 N GRANT ST UNIT 123
DENVER CO
80203-1127
US

V. Phone/Fax

Practice location:
  • Phone: 303-506-9295
  • Fax:
Mailing address:
  • Phone: 303-506-9295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number0127075
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: