| Doctor Name: | MELANIE BECKER LOPEZ |
| NPI Number: | 1023369477 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C |
| License Number: | RN056928 |
| Business Practice Address: | 1960 Riverside Pkwy Suite 101 Lawrenceville, GA - 300435945 |
| Business Phone Number: | 7709950466 |
| Business Fax Number: | 7709950472 |
| Mailing Address: | 1960 Riverside Pkwy, Suite 101 LAWRENCEVILLE |
| State: | GA |
| Postal Code: | 300435945 |
| Phone Number: | 7709950466 |
| Fax Number: | 7709950472 |
| NPI Enumeration Date: | 09/25/2012 |
| NPI Last Update Date: | 09/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | RN056928 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |