Individual
SUSAN O LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1730 W 25TH ST, CLEVELAND, OH 44113-3108
(216) 696-4300
Mailing address
PO BOX 74216, CLEVELAND, OH 44194-0002
(440) 879-0081
(440) 879-0084
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP-07314
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000353974
ANTHEM
OH
05
—
2525422
—
OH
01
—
P00205905
RAILROAD MEDICARE
OH
Enumeration date
02/28/2006
Last updated
09/09/2015
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