Individual
TARA OLIVIA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2360 E PERSHING BLVD, CHEYENNE, WY 82001-5356
(307) 369-3698
Mailing address
2360 E PERSHING BLVD, CHEYENNE, WY 82001-5356
(307) 369-3698
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
48927
WY
Other
Enumeration date
08/29/2024
Last updated
08/29/2024
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