Mason Taylor Lopez, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Comstock Park, MI
NPI 1407627342 · NPPES record last updated Jan 10, 2024
Key facts
- NPI
- 1407627342
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 4704341520 (MI)
- Practice address
- 5320 Rusche Dr NW
Comstock Park, MI 49321-9551 - Phone
- (800) 442-7779
- NPI assigned
- Jan 10, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704341520 | MI | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704341520 | MI | Yes |
Addresses
Primary practice location
5320 Rusche Dr NW
Comstock Park, MI 49321-9551
Mailing address
5337 Lawndale Ave
Hudsonville, MI 49426-1231
Phone (616) 835-6626
Other providers in Comstock Park, MI
- Kent Pediatrics, PC
- Vicky Lynne Klaassen
- Daniel K Koschtial
- Legacy Family Chiropractic
- Carlie Little
- Siew Kheng Loy-O'Shea
- Luminary Home Care LLC
- Megan Malinowski
- Melissa Malinowski
- Sherri Lynn Martin
All providers in Comstock Park, MI · Family Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.