Provider Demographics
NPI:1790380848
Name:LOVE, MEGHAN (MS, FNP-BC)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:LOVE
Suffix:
Gender:F
Credentials:MS, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 LANDWARD DR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-9304
Mailing Address - Country:US
Mailing Address - Phone:914-391-8591
Mailing Address - Fax:
Practice Address - Street 1:107 LANDWARD DR
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-9304
Practice Address - Country:US
Practice Address - Phone:914-391-8591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11008987207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine