Most Relevant Information
Provider Data
| NPI Number: | 1003500794 |
| Provider Name: | ANGELICA LOPEZ FNP-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | 209027597 |
Most Important Dates
| Enumeration Date: | 06/06/2023 |
| Last Updated: | 06/06/2023 |
Provider Practice Location
303 N JACKSON ST
MORRISON
IL
612703042
Practice Location Phone/Fax
| Phone: | 8157724003 |
| Fax: |
Provider Mailing Location
303 N JACKSON ST
MORRISON
IL
612703042
Provider Mailing Phone/Fax
| Phone: | 8157724003 |
| Fax: |