Provider Demographics
NPI:1720176472
Name:LOPEZ, ANDRIA ELAINE (NP)
Entity Type:Individual
Prefix:MRS
First Name:ANDRIA
Middle Name:ELAINE
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ANDRIA
Other - Middle Name:ELAINE
Other - Last Name:RINALDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:730 CENTAURI CT
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-1993
Mailing Address - Country:US
Mailing Address - Phone:970-424-0669
Mailing Address - Fax:
Practice Address - Street 1:2470 F RD STE 8
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-1279
Practice Address - Country:US
Practice Address - Phone:970-245-6911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP16749363LF0000X
CO125949363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily