Provider Demographics
NPI:1578274924
Name:LOZADA, CARMEN MARIA
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:MARIA
Last Name:LOZADA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 W HIGH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26537-1464
Mailing Address - Country:US
Mailing Address - Phone:417-294-6500
Mailing Address - Fax:
Practice Address - Street 1:106 W HIGH ST APT 3
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:WV
Practice Address - Zip Code:26537-1464
Practice Address - Country:US
Practice Address - Phone:417-294-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant