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Individual

MR. MIGUEL ERNESTO LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
FNP-C

Contact information

Practice address
3433 W SIERRA VISTA DR, PHOENIX, AZ 85017-1446
(520) 548-8050
Mailing address
3433 W SIERRA VISTA DR, PHOENIX, AZ 85017-1446
(520) 548-8050

Taxonomy

Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
RN154332
AZ
363LF0000X
Family Nurse Practitioner
Primary
308950
AZ

Other

Enumeration date
06/03/2024
Last updated
06/14/2024
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