Provider Demographics
NPI:1629865001
Name:LOPEZ, KAYLA MARIA
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:MARIA
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:PO BOX 204
Mailing Address - Street 2:
Mailing Address - City:FAITH
Mailing Address - State:NC
Mailing Address - Zip Code:28041-0204
Mailing Address - Country:US
Mailing Address - Phone:980-432-6131
Mailing Address - Fax:
Practice Address - Street 1:1475 LEGION CLUB RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28146
Practice Address - Country:US
Practice Address - Phone:980-432-6131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Single Specialty