MEDICARE: KRISTIN LOVE

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	163WC0200X	Critical Care Medicine Registered Nurse	808027	CA
2	367500000X	Certified Registered Nurse Anesthetist	1070340	TX
3	367500000X	Certified Registered Nurse Anesthetist	95002389	CA

General Provider Information

NPI Number	:	1831769256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN LOVE

Provider Business Mailing Address
First Line	:	2568 LA CANADA AVE
Second Line	:
City	:	CLOVIS
State	:	CA
Zip	:	93619-8596
Country	:	US
Telephone Number	:	323-840-5169
Fax Number	:

Provider Business Practice Location Address
First Line	:	2568 LA CANADA AVE
Second Line	:
City	:	CLOVIS
State	:	CA
Zip	:	93619-8596
Country	:	US
Telephone Number	:	323-840-5169
Fax Number	:

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

Provider Enumeration Date	:	06/28/2021
Last Update Date	:	01/05/2026

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Directions to “ KRISTIN LOVE ” Practice Location

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