Individual
MRS. LISA G LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1112 E ASCENSION COMPLEX BLVD, GONZALES, LA 70737-4265
(225) 621-5775
Mailing address
18133 JUDY DR, PRAIRIEVILLE, LA 70769-3396
(225) 677-8825
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
820670
LA
Other
Enumeration date
05/16/2007
Last updated
07/08/2007
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