Provider Demographics
NPI:1538268065
Name:LOPEZ, SCOTT FRANK (CNS,NP,CRNFA,RNFA)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:FRANK
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:CNS,NP,CRNFA,RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6053 E GRANT RD STE B
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2370
Mailing Address - Country:US
Mailing Address - Phone:520-400-8364
Mailing Address - Fax:
Practice Address - Street 1:2304 N ROSEMONT BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2139
Practice Address - Country:US
Practice Address - Phone:520-400-8364
Practice Address - Fax:520-347-4302
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ095824163WR0006X
AZ047414174400000X
AZ0038364SM0705X
AZAP6070364SP2800X
AZAP1699363LF0000X
AZRN073883163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
No174400000XOther Service ProvidersSpecialist
No364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical
No364SP2800XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPerioperative
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AS758055 02Medicaid
AZ758055Medicaid
AS758055 02Medicaid
AZ73732Medicare ID - Type UnspecifiedNP
AZ758055Medicaid