Provider Demographics
NPI:1134678931
Name:LOPEZ, CARLOTTA VIRGINIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:CARLOTTA
Middle Name:VIRGINIA
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2217 CHAMPA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-2531
Mailing Address - Country:US
Mailing Address - Phone:720-398-9666
Mailing Address - Fax:720-502-5082
Practice Address - Street 1:2217 CHAMPA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-2531
Practice Address - Country:US
Practice Address - Phone:720-398-9666
Practice Address - Fax:720-502-5082
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0125420163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse