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General NPI Number Information
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NPI Number | 1447958004
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Entity Type | Organization
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Legal Business Name | FLOREZ INTEGRATED PSYCHIATRIC SERVICES LLC
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Dates
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Enumeration Date | 02/22/2023
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 204 E 25TH ST STE 2
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City | KEARNEY
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State | NE
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Zip | 68847-4569
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Country | US
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Telephone | 308-270-0368
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Fax | 308-270-0080
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Provider Business Mailing Address
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Address Line | PO BOX 164
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City | KEARNEY
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State | NE
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Zip | 68848-0164
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Country | US
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Telephone | 308-270-0368
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Fax | 308-270-0080
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Authorized Official
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Title or Position | PMHNP
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Name | GARNELLE ELIZABETH FLOREZ
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Credential | NURSE PRACTITIONER
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Telephone | 308-224-1053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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