Healthcare Provider Details

I. General information

NPI: 1225773252
Provider Name (Legal Business Name): NASTASSJA FLOURE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2022
Last Update Date: 05/04/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 BROMPTON CT
TOLEDO OH
43615-6017
US

IV. Provider business mailing address

163 BROMPTON CT
TOLEDO OH
43615-6017
US

V. Phone/Fax

Practice location:
  • Phone: 567-215-7903
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: