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General NPI Number Information
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NPI Number | 1811666795
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Entity Type | Individual
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Provider Name | SULY AIME LOPEZ NP
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Gender | Female
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Dates
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Enumeration Date | 09/13/2021
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 16716 E PALISADES BLVD STE 101B
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City | FOUNTAIN HILLS
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State | AZ
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Zip | 85268-3846
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Country | US
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Telephone | 480-587-5738
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Fax |
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Provider Business Mailing Address
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Address Line | 16716 E PALISADES BLVD STE 101B
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City | FOUNTAIN HILLS
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State | AZ
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Zip | 85268-3846
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Country | US
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Telephone | 541-272-2333
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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 | 202108976NP-PP
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License Number State | OR
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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 | 307652
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License Number State | AZ
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