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General NPI Number Information
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NPI Number | 1033238597
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Entity Type | Individual
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Provider Name | JOANN LOVE M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 03/27/2014
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Provider Practice Location Address
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Address Line | 565 DANIELS ST
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City | T OR C
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State | NM
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Zip | 87901-3319
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Country | US
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Telephone | 575-740-0427
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Fax | 575-894-0777
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Provider Business Mailing Address
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Address Line | 565 DANIELS ST
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City | TRUTH OR CONSEQUENCES
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State | NM
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Zip | 87901-3319
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Country | US
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Telephone | 575-740-0427
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Fax | 575-894-0777
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 20050468
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 20050468
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License Number State | NM
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