Provider Demographics
NPI:1881431690
Name:LOPEZ, KIMBERLY ANNE (FNP-C)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANNE
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39755 MURRIETA HOT SPRINGS RD STE E120
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-9115
Mailing Address - Country:US
Mailing Address - Phone:951-461-1331
Mailing Address - Fax:888-696-2614
Practice Address - Street 1:39755 MURRIETA HOT SPRINGS RD STE E120
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-9115
Practice Address - Country:US
Practice Address - Phone:951-461-1331
Practice Address - Fax:888-696-2614
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030836363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily