Individual
KYLIE MARIE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
5555 W THUNDERBIRD RD, GLENDALE, AZ 85306-4622
(608) 865-5555
Mailing address
21204 W BERKELEY RD, BUCKEYE, AZ 85396-2405
(623) 313-8006
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
228687
AZ
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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