Individual
VANESSA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
825 CHALKSTONE AVE, PROVIDENCE, RI 02908-4728
(401) 456-2000
Mailing address
825 CHALKSTONE AVE, PROVIDENCE, RI 02908-4728
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN04159
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
050444312
—
RI
Enumeration date
04/26/2016
Last updated
08/13/2024
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