Individual
MS. GRISELDA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
100 STATE AVE, FARIBAULT, MN 55021-6337
(504) 334-3921
Mailing address
100 STATE AVE, FARIBAULT, MN 55021-6337
(507) 334-3921
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
6082
MN
Other
Enumeration date
08/24/2018
Last updated
03/11/2021
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