Doctor Name: | TARA TERESA FLORES |
NPI Number: | 1447536685 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 53-75461-032 |
Business Practice Address: | 1301 Platte Falls Rd Platte City, MO - 640797281 |
Business Phone Number: | 8663892727 |
Business Fax Number: | |
Mailing Address: | 7110 Fonticello St, PRAIRIE VILLAGE |
State: | KS |
Postal Code: | 662082343 |
Phone Number: | 2102731050 |
Fax Number: | |
NPI Enumeration Date: | 11/02/2011 |
NPI Last Update Date: | 11/28/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 53-75461-032 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |