Provider Demographics
NPI:1336944768
Name:LOPES, MARIA JOSE (DNP, CPNP-PC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:JOSE
Last Name:LOPES
Suffix:
Gender:
Credentials:DNP, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3561 LYNLEY MILL LN
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-5054
Mailing Address - Country:US
Mailing Address - Phone:678-949-7840
Mailing Address - Fax:
Practice Address - Street 1:3780 HOLCOMB BRIDGE RD
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-4855
Practice Address - Country:US
Practice Address - Phone:770-263-9101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-18
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN316810363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics