Provider Demographics
NPI:1700483989
Name:BECERRA LOPEZ, JANET (RN)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:
Last Name:BECERRA LOPEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 MAIN ST APT 8D
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2126
Mailing Address - Country:US
Mailing Address - Phone:862-206-9874
Mailing Address - Fax:
Practice Address - Street 1:555 MAIN ST APT 8D
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2126
Practice Address - Country:US
Practice Address - Phone:862-206-0808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR19273600163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse