Healthcare Provider Details

I. General information

NPI: 1427414960
Provider Name (Legal Business Name): HOLLY FLORES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2016
Last Update Date: 01/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11059 E BETHANY DR
AURORA CO
80014-2622
US

IV. Provider business mailing address

1086 S DAHLIA ST APT I-402
GLENDALE CO
80246-4203
US

V. Phone/Fax

Practice location:
  • Phone: 303-617-2300
  • Fax: 303-617-2365
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN.1637136
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: