Individual ProviderJennifer LopezNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address9604 Holly Point Dr, Huntersville, NC 28078-4913(704) 316-5070PECOS EnrollmentBased on the most recent information from CMS, provider Jennifer Lopez is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records today at 10:49 AM.Profile DetailsProvider ID1386182756Provider TypeIndividualFull NameLopez, JenniferCredentialFNPGenderFemaleSole ProprietorNoEnumeration Date2/6/2017Last Updated10/30/2024Contact InformationPractice LocationPractice Address9604 Holly Point Dr, Huntersville, NC 28078-4913Phone(704) 316-5070Fax(704) 316-5075Mailing LocationMailing Address9604 Holly Point Dr, Huntersville, NC 28078-4913Phone(704) 316-5070Fax(704) 316-5075Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense5009258North CarolinaCode363L00000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense5009258North Carolina