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General NPI Number Information
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NPI Number | 1053897967
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Entity Type | Individual
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Provider Name | ERIN NICOLE LOPEZ PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/13/2018
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Last Update Date | 12/24/2024
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Provider Practice Location Address
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Address Line | 15237 CREATIVITY DR
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City | CULPEPER
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State | VA
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Zip | 22701-2504
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Country | US
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Telephone | 540-321-4281
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Fax |
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Provider Business Mailing Address
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Address Line | 8700 SUDLEY RD
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City | MANASSAS
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State | VA
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Zip | 20110-4418
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Country | US
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Telephone | 703-369-8000
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110006316
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License Number State | VA
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