MEDICARE: CASSANDRA LOVE APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	A005845	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144705047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA LOVE APRN

Provider Business Mailing Address
First Line	:	74 WESTFIELD LOOP
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72210-6942
Country	:	US
Telephone Number	:	501-240-5951
Fax Number	:

Provider Business Practice Location Address
First Line	:	74 WESTFIELD LOOP
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72210-6942
Country	:	US
Telephone Number	:	501-240-5951
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2018
Last Update Date	:	04/18/2023

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Directions to “ CASSANDRA LOVE APRN” Practice Location

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