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Individual

MISS ANASTASIA JESSICA LOPEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
9801 W VAN BUREN ST, TOLLESON, AZ 85353-2833
(623) 478-4000
Mailing address
8536 W MAGNOLIA ST, TOLLESON, AZ 85353-8737
(602) 643-8639

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
303118
AZ

Other

Enumeration date
07/26/2024
Last updated
07/26/2024
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