Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 254868 | TX |
NPI | 1033224084 |
---|---|
Provider Name | Terri Dotson Love |
First Address | Bayfield, CO 81122-9732 |
Second Address | El Paso, TX 79925-7701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 08/07/2007 |