Provider Demographics
NPI:1861021941
Name:LOPEZ, MICHELLE CARTER (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:CARTER
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 57TH AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-1459
Mailing Address - Country:US
Mailing Address - Phone:502-500-5315
Mailing Address - Fax:
Practice Address - Street 1:1505 57TH AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-1459
Practice Address - Country:US
Practice Address - Phone:502-500-5315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27414363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily