Healthcare Provider Details

I. General information

NPI: 1578305504
Provider Name (Legal Business Name): EMILY ELENA LOPEZ DNP-PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2024
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1233 N 30TH ST
BILLINGS MT
59101-0127
US

IV. Provider business mailing address

1233 N 30TH ST
BILLINGS MT
59101-0127
US

V. Phone/Fax

Practice location:
  • Phone: 406-657-7000
  • Fax:
Mailing address:
  • Phone: 801-513-9288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number290550
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: