Provider Demographics
NPI:1043095177
Name:LOPEZ, KEMBERLYN TORRECARION (RN)
Entity type:Individual
Prefix:MS
First Name:KEMBERLYN
Middle Name:TORRECARION
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2739 MORGAN AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-5520
Mailing Address - Country:US
Mailing Address - Phone:646-592-5623
Mailing Address - Fax:
Practice Address - Street 1:2739 MORGAN AVE FL 1
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5520
Practice Address - Country:US
Practice Address - Phone:646-592-5623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY762762163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY431084431OtherNEW YORK STATE LEARNER PERMIT