MEDICARE: NELSON LOPEZ-HERRERA

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
1	374U00000X	Home Health Aide		DC

General Provider Information

NPI Number	:	1992526610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NELSON LOPEZ-HERRERA

Provider Business Mailing Address
First Line	:	6910 DECATUR PL
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20784-1526
Country	:	US
Telephone Number	:	240-714-1592
Fax Number	:

Provider Business Practice Location Address
First Line	:	6910 DECATUR PL
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20784-1526
Country	:	US
Telephone Number	:	240-714-1592
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2024
Last Update Date	:	10/24/2024

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Directions to “ NELSON LOPEZ-HERRERA ” Practice Location

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