Individual provider · Type 1 NPI

Staci E. Lopez-Vergara, CPNP

Pediatric Nurse Practitioner · Fort Worth, TX

NPI number 1407191323 Active

Practice location

9840 N Beach St
Fort Worth, TX 76244-6184

Fax (817) 379-1161

Mailing address

PO Box 733784
Dallas, TX 75373-3784

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner 363LP0200X755740 (TX)
Primary Care Nurse Practitioner 363LP2300XAP122615 (TX)
Pediatric Nurse Practitioner Primary 363LP0200XAP122615 (TX)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1407191323

Staci E. Lopez-Vergara, CPNP's National Provider Identifier is 1407191323, issued on Dec 4, 2012. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Fort Worth, TX. The record was last updated on May 14, 2024.