Individual
MISTY RENEE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2052 W BUENA VISTA ST, SPRINGFIELD, MO 65810-1511
(417) 315-4911
Mailing address
PO BOX 802843, KANSAS CITY, MO 64180-2843
(417) 730-6430
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2005015559
MO
Other
Enumeration date
09/27/2006
Last updated
02/10/2026
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