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Individual

JENNIFER LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
407 S SCHWARTZ AVE STE 101, FARMINGTON, NM 87401-5925
(505) 609-6595
(505) 599-4633
Mailing address
19 ROAD 5251, BLOOMFIELD, NM 87413-9720
(970) 749-9227

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
76370
NM

Other

Enumeration date
10/18/2023
Last updated
06/12/2024
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