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NPI Code Detail

MEDICARE: MRS. KATHLEEN SUZANNE FLOREA NP

MEDICARE: MRS. KATHLEEN SUZANNE FLOREA NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP2900AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275527764
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHLEEN SUZANNE FLOREA NP
Provider Business Mailing Address
First Line : PO BOX 3630
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86003-3630
Country : US
Telephone Number : 928-233-5110
Fax Number : 928-774-6687
Provider Business Practice Location Address
First Line : 1510 STOCKTON HILL RD
Second Line :
City : KINGMAN
State : AZ
Zip : 86401-5173
Country : US
Telephone Number : 928-753-1177
Fax Number : 928-753-1178
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2005
Last Update Date : 12/31/2014

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