Provider Demographics
NPI:1831629716
Name:LOPEZ, KATHERINE EVELYN
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:EVELYN
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 1:65 ASHLAND AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-7008
Mailing Address - Country:US
Mailing Address - Phone:978-884-4075
Mailing Address - Fax:
Practice Address - Street 1:65 ASHLAND AVE FL 3
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-7008
Practice Address - Country:US
Practice Address - Phone:978-884-4075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program