Individual
ELLYSE LOPEZ LAMONT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
186 EASTERN BLVD N, HAGERSTOWN, MD 21740-5843
(301) 302-7837
Mailing address
203 CHARTERHOUSE ST, FALLING WATERS, WV 25419-1698
(240) 818-7400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
AP135273
TX
363LF0000X
Family Nurse Practitioner
AP135273
TX
363LF0000X
Family Nurse Practitioner
Primary
R131456
MD
Other
Enumeration date
10/02/2017
Last updated
05/17/2023
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