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NPI Code Detail

MEDICARE: MRS. JENNIFER ELIZABETH LOPEZ RN

MEDICARE: MRS. JENNIFER ELIZABETH LOPEZ RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseR199409MD

General Provider Information

NPI Number : 1104165364
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER ELIZABETH LOPEZ RN
Provider Business Mailing Address
First Line : 6010 CALIFORNIA CIR APT 209
Second Line :
City : ROCKVILLE
State : MD
Zip : 20852-4852
Country : US
Telephone Number : 301-367-5207
Fax Number :
Provider Business Practice Location Address
First Line : 8210 COLONIAL LN
Second Line :
City : SILVER SPRING
State : MD
Zip : 20910-5721
Country : US
Telephone Number : 301-585-1250
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2013
Last Update Date : 02/07/2013

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