Provider Demographics
NPI:1750603163
Name:LOPEZ, KAREN LYNN (CNA, MA)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LYNN
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:CNA, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 SOUTH CARROLL AVE
Mailing Address - Street 2:#106
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46360
Mailing Address - Country:US
Mailing Address - Phone:219-221-6138
Mailing Address - Fax:
Practice Address - Street 1:910 SOUTH CARROLL AVE
Practice Address - Street 2:#106
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360
Practice Address - Country:US
Practice Address - Phone:219-221-6138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INCNA0906865376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide