Healthcare Provider Details

I. General information

NPI: 1740199934
Provider Name (Legal Business Name): KATHY FLORES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2930 11TH AVE
EVANS CO
80620-1011
US

IV. Provider business mailing address

3118 19TH STREET RD
GREELEY CO
80634-5742
US

V. Phone/Fax

Practice location:
  • Phone: 970-353-9403
  • Fax:
Mailing address:
  • Phone: 915-422-9445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRN.1698596
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: