Most Relevant Information
Provider Data
| NPI Number: | 1003442278 |
| Provider Name: | JACOB LOVELESS NURSE PRACTITIONER |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | R0109553 |
Most Important Dates
| Enumeration Date: | 03/19/2020 |
| Last Updated: | 08/02/2021 |
Provider Practice Location
818 N EMPORIA ST STE 200
WICHITA
KS
672143788
Practice Location Phone/Fax
| Phone: | 3162630296 |
| Fax: |
Provider Mailing Location
551 N HILLSIDE ST STE 201
WICHITA
KS
672144923
Provider Mailing Phone/Fax
| Phone: | 3162630296 |
| Fax: | 3162639523 |