Individual
KIMBERLY BLACKWELL LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1150 N INDIAN CANYON DR, PALM SPRINGS, CA 92262-4872
(808) 854-7133
Mailing address
58607 PIEDMONT DR, YUCCA VALLEY, CA 92284-6408
(808) 854-7133
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
95001342
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/14/2020
Last updated
03/12/2023
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