Individual
MR. JUAN JOSE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, FNP-C
Contact information
Practice address
6223 N 21ST DR, PHOENIX, AZ 85015-1902
(623) 419-2799
Mailing address
6223 N 21ST DR, PHOENIX, AZ 85015-1902
(623) 419-2799
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN172210
AZ
363LF0000X
Family Nurse Practitioner
Primary
AP7356
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004494
—
AZ
Enumeration date
11/02/2013
Last updated
06/23/2025
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