Individual
KIMBERLY K LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5401 N KNOXVILLE AVE, SUITE 416, PEORIA, IL 61614-5098
(309) 692-7246
Mailing address
5401 N KNOXVILLE AVE, SUITE 416, PEORIA, IL 61614-5098
(309) 692-7246
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209014626
IL
Other
Enumeration date
08/16/2016
Last updated
08/16/2016
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