Individual
IVONNE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
200 E RYAN RD, OAK CREEK, WI 53154-4563
(414) 570-3590
Mailing address
200 E RYAN RD, OAK CREEK, WI 53154-4563
(414) 570-3590
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5258
WI
Other
Enumeration date
03/28/2013
Last updated
01/25/2018
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