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General NPI Number Information
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NPI Number | 1720176472
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Entity Type | Individual
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Provider Name | ANDRIA ELAINE LOPEZ NP
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Gender | Female
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 08/12/2008
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Provider Practice Location Address
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Address Line | 2470 F RD STE 8
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City | GRAND JUNCTION
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State | CO
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Zip | 81505-1279
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Country | US
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Telephone | 970-245-6911
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Fax |
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Provider Business Mailing Address
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Address Line | 730 CENTAURI CT
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City | GRAND JUNCTION
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State | CO
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Zip | 81506-1993
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Country | US
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Telephone | 970-424-0669
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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 | NP16749
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License Number State | CA
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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 | 125949
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License Number State | CO
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