Provider Demographics
NPI:1285249763
Name:LOVE, KRYSTIN MARIE (MS, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KRYSTIN
Middle Name:MARIE
Last Name:LOVE
Suffix:
Gender:F
Credentials:MS, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8034 E BRAINERD RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3205
Mailing Address - Country:US
Mailing Address - Phone:423-894-3836
Mailing Address - Fax:
Practice Address - Street 1:8034 E BRAINERD RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3205
Practice Address - Country:US
Practice Address - Phone:423-894-3836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-11
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11008682363LF0000X
TN28281363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily