Individual
KELLY LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FPN
Contact information
Practice address
320 N MAIN ST, BELEN, NM 87002-3716
(505) 361-1167
Mailing address
320 N MAIN ST, BELEN, NM 87002-3716
(623) 910-2777
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN1630486
CO
363LF0000X
Family Nurse Practitioner
Primary
APN.0996117-NP
CO
Other
Enumeration date
03/29/2016
Last updated
11/30/2023
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