Provider Demographics
NPI:1043277809
Name:LOVE, ROBIN L (FNP)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:L
Last Name:LOVE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 NORTH ST STE 207
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4123
Mailing Address - Country:US
Mailing Address - Phone:413-499-8510
Mailing Address - Fax:413-499-8553
Practice Address - Street 1:777 NORTH ST STE 207
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4123
Practice Address - Country:US
Practice Address - Phone:413-499-8510
Practice Address - Fax:413-499-8553
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA178621363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0357073Medicaid
MA0357073Medicaid
NP1637Medicare ID - Type Unspecified