Individual
AIDA LUZ LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3242 W 112TH ST, CLEVELAND, OH 44111-2719
(216) 973-9965
Mailing address
3242 W 112TH ST, CLEVELAND, OH 44111-2719
(216) 973-9965
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
108733
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108733
OHIO BOARD OF NURSING
OH
Enumeration date
11/15/2012
Last updated
11/15/2012
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