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General NPI Number Information
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NPI Number | 1629676044
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Entity Type | Individual
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Provider Name | DORALIA YANELY FLORES FNP
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Gender | Female
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Dates
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Enumeration Date | 10/16/2020
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Last Update Date | 09/07/2022
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Provider Practice Location Address
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Address Line | 410 E 22ND ST STE 1
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City | FREMONT
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State | NE
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Zip | 68025-2640
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Country | US
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Telephone | 402-727-7979
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Fax | 402-727-9306
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Provider Business Mailing Address
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Address Line | 410 E 22ND ST STE 100
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City | FREMONT
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State | NE
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Zip | 68025-2639
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Country | US
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Telephone | 402-727-7979
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Fax | 402-727-9306
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | AP142984
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 113720
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License Number State | NE
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