Individual
LATOSHA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2196 WHITE BEAR AVE N, MAPLEWOOD, MN 55109-2708
(651) 704-3022
Mailing address
3153 164TH AVE NW, ANDOVER, MN 55304-2451
(612) 290-1514
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
9465
MN
Other
Enumeration date
08/29/2022
Last updated
08/29/2022
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