Individual
MARIAH LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
7012 N 56TH AVE, GLENDALE, AZ 85301-2516
(602) 877-3931
Mailing address
14173 N 136TH LN, SURPRISE, AZ 85379-8458
(360) 451-9807
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
354960
AZ
Other
Enumeration date
07/01/2025
Last updated
07/01/2025
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