Individual
MS. NANCY LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2100 STANTONSBURG RD, GREENVILLE, NC 27834-2818
(252) 847-0782
Mailing address
2100 STANTONSBURG RD, GREENVILLE, NC 27834-2818
(252) 752-5077
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0010-06595
NC
363AS0400X
Surgical Physician Assistant
010394
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02716833
—
NY
Enumeration date
11/10/2005
Last updated
12/08/2020
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