Individual
MS. KEISHA KENNESHA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13 SOUTH ST STE 1, NORWALK, CT 06854-2660
(203) 434-5211
(203) 354-5702
Mailing address
13 SOUTH ST, APT 1, NORWLK, CT 06854
(203) 434-5211
(203) 354-5702
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
038954
CT
164W00000X
Licensed Practical Nurse
Primary
320663-1
NY
Other
Enumeration date
02/09/2015
Last updated
02/09/2015
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