Provider Demographics
NPI:1841455698
Name:LONDON-LOPES, KATHLEEN D (CNM)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:D
Last Name:LONDON-LOPES
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-3744
Mailing Address - Country:US
Mailing Address - Phone:508-672-3700
Mailing Address - Fax:508-672-5442
Practice Address - Street 1:484 HIGHLAND AVENUE
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3704
Practice Address - Country:US
Practice Address - Phone:508-672-3700
Practice Address - Fax:508-672-5442
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA237841367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0719501Medicaid
MA000748301Medicare PIN