Individual
SANDRA JANE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CHA IV
Contact information
Practice address
65 AIRPORT RD, COLD BAY, AK 99571
(907) 532-2000
(907) 532-2001
Mailing address
3380 C STREET,, STE. 100, ANCHORAGE, AK 99503-3949
(907) 277-1440
(907) 277-1446
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
08-964-III
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CL6515
—
AK
Enumeration date
05/03/2010
Last updated
05/03/2010
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