Individual
ERNESTINA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN-73580
Contact information
Practice address
520 N MAIN ST, BELEN, NM 87002-3720
(505) 966-2207
Mailing address
PO BOX 501, SOCORRO, NM 87801-0501
(505) 205-7350
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN-73580
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
163WS0200X
TAXONOMY NUMBER
NM
Enumeration date
12/17/2013
Last updated
12/17/2013
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