Provider Demographics
NPI:1942702683
Name:LOPEZ CONTRERAS, KATHERINE GUISSELL (LVN)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:GUISSELL
Last Name:LOPEZ CONTRERAS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:GUISSELL
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:7346 AZALEA SQ
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-3109
Mailing Address - Country:US
Mailing Address - Phone:210-240-8531
Mailing Address - Fax:
Practice Address - Street 1:3201 CHERRY RIDGE ST STE D400
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4820
Practice Address - Country:US
Practice Address - Phone:210-692-0222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-07
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX330113164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse