Individual
ERICA J LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
502 ELM ST NE, ALBUQUERQUE, NM 87102-2512
(505) 841-1000
(505) 843-2853
Mailing address
502 ELM ST NE, ALBUQUERQUE, NM 87102-2512
(505) 841-1000
(505) 843-2853
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA2006-0018
NM
363AS0400X
Surgical Physician Assistant
Primary
PA2006-0018
NM
Other
Enumeration date
06/27/2006
Last updated
02/29/2012
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