Healthcare Provider Details

I. General information

NPI: 1194634998
Provider Name (Legal Business Name): GABRIEL DAI LOPEZ BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

100 W H ST
BUTNER NC
27509-1605
US

IV. Provider business mailing address

100 W H ST
BUTNER NC
27509-1605
US

V. Phone/Fax

Practice location:
  • Phone: 919-338-8500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number348992
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: