Individual
MRS. MAIRA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1811 CHARLTON CT, GOSHEN, IN 46526-6464
(574) 534-8200
(574) 807-9313
Mailing address
1811 CHARLTON CT, GOSHEN, IN 46526-6464
(574) 534-8200
(574) 807-9313
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71012728A
IN
Other
Enumeration date
07/13/2022
Last updated
07/13/2022
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