Healthcare Provider Details

I. General information

NPI: 1700507126
Provider Name (Legal Business Name): ALEXIS CATHLEEN LOPEZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2022
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6630 E CARONDELET DR
TUCSON AZ
85710-2119
US

IV. Provider business mailing address

941 N GADSDEN PL
TUCSON AZ
85710-2643
US

V. Phone/Fax

Practice location:
  • Phone: 520-343-3775
  • Fax:
Mailing address:
  • Phone: 520-343-3775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number247653
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: