Individual
SUEANNY TAMARA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
525 N WOLFE ST, BALTIMORE, MD 21205-2110
(410) 955-4766
Mailing address
525 N WOLFE ST, BALTIMORE, MD 21205-2110
(410) 955-4766
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
R248091
MD
367500000X
Certified Registered Nurse Anesthetist
Primary
143865
NJ
Other
Enumeration date
07/02/2021
Last updated
02/22/2024
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