Basic Information
| Provider Information | |||||||||
| NPI: | 1568998755 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FLORES | ||||||||
| FirstName: | CHRISTINA | ||||||||
| MiddleName: | MONIQUE | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | LVN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 705 TAZA VERDE AVE | ||||||||
| Address2: | |||||||||
| City: | NORTH LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 890312396 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2133186575 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1536 N BOULDER HWY | ||||||||
| Address2: | |||||||||
| City: | HENDERSON | ||||||||
| State: | NV | ||||||||
| PostalCode: | 890114120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7025588600 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2017 | ||||||||
| LastUpdateDate: | 04/26/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164X00000X | 287491 | CA | N | Nursing Service Providers | Licensed Vocational Nurse | 164W00000X | LPN16713 | NV | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.