| Doctor Name: | IVONNE LOPEZ |
| NPI Number: | 1457694432 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 5258-33 |
| Business Practice Address: | 100 15th Ave South Milwaukee, WI - 531721160 |
| Business Phone Number: | 4147643241 |
| Business Fax Number: | 4145703599 |
| Mailing Address: | 100 15th Ave, SOUTH MILWAUKEE |
| State: | WI |
| Postal Code: | 531721160 |
| Phone Number: | 4147643241 |
| Fax Number: | 4147624225 |
| NPI Enumeration Date: | 03/28/2013 |
| NPI Last Update Date: | 06/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 5258-33 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |