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General NPI Number Information
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NPI Number | 1326903154
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Entity Type | Individual
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Provider Name | BRIELLE LOPEZ MS,RN
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Gender | Female
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Dates
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Enumeration Date | 12/23/2025
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 4280 E CAMELBACK RD STE 150
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City | PHOENIX
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State | AZ
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Zip | 85018-2754
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Country | US
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Telephone | 480-573-0082
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Fax |
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Provider Business Mailing Address
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Address Line | 5200 S LAKESHORE DR APT 202
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City | TEMPE
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State | AZ
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Zip | 85283-1498
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Country | US
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Telephone | 480-781-4016
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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 | 163WS0121X
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Taxonomy Name | Plastic Surgery Registered Nurse
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License Number | 333167
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License Number State | AZ
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