MEDICARE: JESSICA ANN LOVE CRNP

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	363LF0000X	Family Nurse Practitioner	SP033731	PA

General Provider Information

NPI Number	:	1639040140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA ANN LOVE CRNP

Provider Business Mailing Address
First Line	:	100 EXCELA HEALTH DR STE 203
Second Line	:
City	:	LATROBE
State	:	PA
Zip	:	15650-9001
Country	:	US
Telephone Number	:	724-539-6320
Fax Number	:	724-539-6333

Provider Business Practice Location Address
First Line	:	100 EXCELA HEALTH DR STE 203
Second Line	:
City	:	LATROBE
State	:	PA
Zip	:	15650-9001
Country	:	US
Telephone Number	:	724-539-6320
Fax Number	:	724-539-6333

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

Provider Enumeration Date	:	09/16/2025
Last Update Date	:	02/02/2026

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Directions to “ JESSICA ANN LOVE CRNP” Practice Location

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