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General NPI Number Information
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NPI Number | 1871217711
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Entity Type | Individual
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Provider Name | KASEY LEA LOVE
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Gender | Female
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Dates
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Enumeration Date | 10/03/2022
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 201 N FANNIN AVE
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City | CAMERON
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State | TX
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Zip | 76520-3363
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Country | US
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Telephone | 254-563-5682
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Fax |
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Provider Business Mailing Address
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Address Line | 505 DAVID DAVIS DR
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City | MC GREGOR
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State | TX
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Zip | 76657-2214
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Country | US
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Telephone | 254-563-5682
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Fax |
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 1095790
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1095790
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License Number State | TX
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