Provider Demographics
NPI:1528831328
Name:LOPEZ, CELENE (APRN, CPNP-AC)
Entity type:Individual
Prefix:
First Name:CELENE
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:APRN, CPNP-AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6536 TOIVOA PL
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79932-2566
Mailing Address - Country:US
Mailing Address - Phone:915-408-8565
Mailing Address - Fax:
Practice Address - Street 1:6536 TOIVOA PL
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79932-2566
Practice Address - Country:US
Practice Address - Phone:915-408-8565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1139837363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics