Provider Demographics
NPI:1134611197
Name:LOVE, CHRISTINA FAYE (NP)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:FAYE
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 1:355 MEDICAL GROUP
Mailing Address - Street 2:4175 S ALAMO AVE
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85707
Mailing Address - Country:US
Mailing Address - Phone:520-228-2778
Mailing Address - Fax:
Practice Address - Street 1:355 MEDICAL GROUP
Practice Address - Street 2:4175 S ALAMO AVE
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85707
Practice Address - Country:US
Practice Address - Phone:520-228-2778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP11316363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics