Provider Demographics
NPI:1790726826
Name:LOVE, CATHERINE S (NP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:S
Last Name:LOVE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2181 HWY 2, EAST
Mailing Address - Street 2:SUITE 9
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901
Mailing Address - Country:US
Mailing Address - Phone:406-756-7225
Mailing Address - Fax:
Practice Address - Street 1:2181 HWY 2, EAST
Practice Address - Street 2:SUITE 9
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901
Practice Address - Country:US
Practice Address - Phone:406-756-7225
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT31601363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT375030OtherBLUE CROSS
MT4306865Medicaid
MT4306865Medicaid
MT375030OtherBLUE CROSS