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Individual

ROSE LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
824 N 99TH AVE, AVONDALE, AZ 85323-5324
(602) 818-3980
Mailing address
PO BOX 552, TOLLESON, AZ 85353-0552
(602) 818-3980

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
309644
AZ

Other

Enumeration date
07/08/2024
Last updated
07/08/2024
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