Individual
DIANA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3889 S JACKSON DR, INDEPENDENCE, MO 64057-1927
(816) 698-8290
(816) 698-8291
Mailing address
303 E 2ND ST, DEARBORN, MO 64439-7108
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2022016386
MO
363LF0000X
Family Nurse Practitioner
53-81318-012
KS
Other
Enumeration date
06/29/2022
Last updated
10/24/2024
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