Healthcare Provider Details

I. General information

NPI: 1861824781
Provider Name (Legal Business Name): JILL MARIE FLORES FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JILL MANNON FLORES NP

II. Dates (important events)

Enumeration Date: 08/01/2013
Last Update Date: 11/09/2025
Certification Date: 11/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1181 E 120TH AVE UNIT A
THORNTON CO
80233-5729
US

IV. Provider business mailing address

4969 E 142ND AVE
THORNTON CO
80602-8924
US

V. Phone/Fax

Practice location:
  • Phone: 303-673-1500
  • Fax:
Mailing address:
  • Phone: 970-593-8453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0991111-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: