Individual
MRS. MARY BETH LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
39 CUMBERLAND GAP PLZ, GRAY, KY 40734-4536
(606) 526-9005
(606) 526-8607
Mailing address
10755 N US HIGHWAY 25E, GRAY, KY 40734-6529
(606) 258-8050
(606) 258-8994
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3008095
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100348960
—
KY
Enumeration date
06/24/2013
Last updated
01/17/2019
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