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General NPI Number Information
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NPI Number | 1013360148
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Entity Type | Individual
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Provider Name | ALISA MARIE LOPEZ CNP
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Gender | Female
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 5320 HARROUN RD
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City | SYLVANIA
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State | OH
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Zip | 43560
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Country | US
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Telephone | 419-824-7419
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Fax | 567-585-9461
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Provider Business Mailing Address
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Address Line | 5855 MONROE ST
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City | SYLVANIA
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State | OH
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Zip | 43560-2269
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Country | US
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Telephone | 419-824-7419
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Fax | 567-585-9461
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.382352
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.019387
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License Number State | OH
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