Provider Demographics
NPI:1548030174
Name:LOPEZ, SHEILA MARIE DELA ROSA (APRN)
Entity type:Individual
Prefix:
First Name:SHEILA MARIE
Middle Name:DELA ROSA
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 PRAIRIE MOON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-1257
Mailing Address - Country:US
Mailing Address - Phone:757-971-7910
Mailing Address - Fax:
Practice Address - Street 1:655 N TOWN CENTER DR
Practice Address - Street 2:SUITE 402
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-6367
Practice Address - Country:US
Practice Address - Phone:702-243-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV811921364SX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology