Provider Demographics
NPI:1104619857
Name:LOPEZ MENDEZ, IRMA
Entity type:Individual
Prefix:
First Name:IRMA
Middle Name:
Last Name:LOPEZ MENDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 HAWTHORNE AVE TRLR 9
Mailing Address - Street 2:
Mailing Address - City:CRETE
Mailing Address - State:NE
Mailing Address - Zip Code:68333-1122
Mailing Address - Country:US
Mailing Address - Phone:531-248-7142
Mailing Address - Fax:
Practice Address - Street 1:2200 HAWTHORNE AVE TRLR 9
Practice Address - Street 2:
Practice Address - City:CRETE
Practice Address - State:NE
Practice Address - Zip Code:68333-1122
Practice Address - Country:US
Practice Address - Phone:531-248-7142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide