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General NPI Number Information
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NPI Number | 1407521123
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Entity Type | Individual
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Provider Name | FLOR I LOPEZ FNP
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Gender | Female
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Dates
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Enumeration Date | 08/13/2021
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Last Update Date | 12/27/2021
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Provider Practice Location Address
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Address Line | 12722 DIRECTORS LOOP
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City | WOODBRIDGE
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State | VA
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Zip | 22192-2462
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Country | US
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Telephone | 703-492-1400
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Fax | 703-492-0220
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Provider Business Mailing Address
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Address Line | 6202 DONCASTER CT
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City | SPRINGFIELD
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State | VA
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Zip | 22150-3320
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Country | US
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Telephone | 703-269-8715
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024182409
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License Number State | VA
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