Individual
CARSON NICOLE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
304 W RUDOLPH ST, CROSSVILLE, IL 62827-1130
(618) 384-8472
Mailing address
304 W RUDOLPH ST, CROSSVILLE, IL 62827-1130
(618) 384-8472
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
IL
Other
Enumeration date
07/31/2024
Last updated
07/31/2024
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