Individual
JENNIFER LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1811 W 2ND ST STE LL200, GRAND ISLAND, NE 68803-5420
(308) 382-1884
Mailing address
1811 W 2ND ST STE LL200, GRAND ISLAND, NE 68803-5420
(308) 382-1884
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
24884
NE
Other
Enumeration date
09/03/2025
Last updated
09/03/2025
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