Individual
SUSAN S LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8081 TOWNSHIP LINE RD STE 203, INDIANAPOLIS, IN 46260-2189
(317) 415-8100
Mailing address
8081 TOWNSHIP LINE RD STE 203, INDIANAPOLIS, IN 46260-2189
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71002538A
IN
363LW0102X
Women's Health Nurse Practitioner
Primary
71002538A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200898610
—
IN
Enumeration date
04/14/2008
Last updated
09/12/2024
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