Provider Demographics
NPI:1255195244
Name:LOPEZ, KRISTYN MARIE
Entity type:Individual
Prefix:
First Name:KRISTYN
Middle Name:MARIE
Last Name:LOPEZ
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 1:14648 W GELDING DR
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-5753
Mailing Address - Country:US
Mailing Address - Phone:602-832-0803
Mailing Address - Fax:
Practice Address - Street 1:14648 W GELDING DR
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379-5753
Practice Address - Country:US
Practice Address - Phone:602-832-0803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula