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Individual
JOSE MANUEL LOPEZ
Active
Individual
JOSE MANUEL LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4000642
KY
261QC1500X
Community Health Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
Primary
4000642
KY
Other
Enumeration date
06/21/2021
Last updated
09/02/2026
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