Individual
JELISSA FERNANDA HERNANDEZ LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
300 W 27TH ST, LUMBERTON, NC 28358-3075
(980) 216-0545
Mailing address
3729 PAULINE LN, CHARLOTTE, NC 28216-8902
(980) 216-0545
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
NC
Other
Enumeration date
04/29/2026
Last updated
04/29/2026
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