Individual
NICHOLE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1202 N BARTON ST, JOHNSON CITY, TN 37604-4208
(205) 306-8992
Mailing address
1202 N BARTON ST, JOHNSON CITY, TN 37604-4208
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/16/2023
Last updated
11/16/2023
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