Provider Demographics
NPI:1841886496
Name:LOPEZ, HEATHRE LYNN
Entity type:Individual
Prefix:MRS
First Name:HEATHRE
Middle Name:LYNN
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 1:8862 JORDAN CT
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-9707
Mailing Address - Country:US
Mailing Address - Phone:808-563-9549
Mailing Address - Fax:
Practice Address - Street 1:25927 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:OLMSTED FALLS
Practice Address - State:OH
Practice Address - Zip Code:44138-1628
Practice Address - Country:US
Practice Address - Phone:808-563-9549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care