Individual
MRS. SHANNON NICOLE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
11350 MCCORMICK RD STE 501, HUNT VALLEY, MD 21031-1002
(703) 738-4371
Mailing address
11350 MCCORMICK RD STE 501, HUNT VALLEY, MD 21031-1002
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110009442
VA
Other
Enumeration date
12/30/2022
Last updated
07/29/2024
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