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NPI 1306322862

NPI 1306322862 : AGNES LOPEZ DNP, FNP : TACOMA, WA

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General NPI Number Information
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    NPI Number           |    1306322862
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    Entity Type          |    Individual 
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    Provider Name        |    AGNES LOPEZ DNP, FNP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/17/2018
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    Last Update Date     |    08/05/2025
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Provider Practice Location Address
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    Address Line         |    3020 S UNION AVE 
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    City                 |    TACOMA
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    State                |    WA
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    Zip                  |    98409-3317
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    Country              |    US
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    Telephone            |    253-844-4327
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    917 PACIFIC AVE STE 600 
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    City                 |    TACOMA
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    State                |    WA
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    Zip                  |    98402-4437
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    Country              |    US
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    Telephone            |    253-844-4327
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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        |    163W00000X
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    Taxonomy Name        |    Registered Nurse
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    License Number       |    RN61438946
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    License Number State |    WA
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Taxonomy #2
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    Taxonomy Code        |    163W00000X
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    Taxonomy Name        |    Registered Nurse
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    License Number       |    95152450
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    License Number State |    CA
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Taxonomy #3
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    Taxonomy Code        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    95022466
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    License Number State |    CA
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Taxonomy #4
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    Taxonomy Code        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    AP61439019
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    License Number State |    WA
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