Individual
MRS. IVETTE LOPEZ AGUEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2301 ERWIN RD # DUMC3094, DURHAM, NC 27705-4699
(919) 668-0289
Mailing address
4027 ADAIR LN, BURLINGTON, NC 27215-9464
(336) 538-4965
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
207539
NC
367500000X
Certified Registered Nurse Anesthetist
79915
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8052596
—
NC
Enumeration date
04/05/2006
Last updated
07/21/2022
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