Provider Demographics
NPI:1821870650
Name:LOPEZ-CULANAG, LORIMEL ADELINE SOBERANO (NP)
Entity Type:Individual
Prefix:
First Name:LORIMEL ADELINE
Middle Name:SOBERANO
Last Name:LOPEZ-CULANAG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LORIMEL ADELINE
Other - Middle Name:SOBERANO
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6843 W TROPICANA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-4923
Mailing Address - Country:US
Mailing Address - Phone:702-888-1113
Mailing Address - Fax:
Practice Address - Street 1:6843 W TROPICANA AVE STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-4923
Practice Address - Country:US
Practice Address - Phone:702-888-1113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNA363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily