Provider Demographics
NPI:1720849276
Name:LYNDA LOPEZ-FREYRE FNP-C PROFESSIONAL NURSING CORPORATION
Entity Type:Organization
Organization Name:LYNDA LOPEZ-FREYRE FNP-C PROFESSIONAL NURSING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ-FREYRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-852-3758
Mailing Address - Street 1:424 BERYL COVE WAY
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-6218
Mailing Address - Country:US
Mailing Address - Phone:562-852-3758
Mailing Address - Fax:
Practice Address - Street 1:424 BERYL COVE WAY
Practice Address - Street 2:
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740-6218
Practice Address - Country:US
Practice Address - Phone:562-852-3758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty