Individual
MRS. WANDA IVETTE LOPEZ-RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1105 ROUTE 46, LEDGEWOOD, NJ 07852
(973) 927-4662
(973) 927-4668
Mailing address
161 MOUNT OLIVE RD, FLANDERS, NJ 07836-9725
(973) 527-4722
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ00325900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F0910124
AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION NUMBER
NJ
Enumeration date
01/11/2011
Last updated
07/11/2016
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