Provider Demographics
NPI:1215606256
Name:FLORES, RACHEL W
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:W
Last Name:FLORES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9408 S STEVEN TRL
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:AZ
Mailing Address - Zip Code:86332-5041
Mailing Address - Country:US
Mailing Address - Phone:623-224-3561
Mailing Address - Fax:
Practice Address - Street 1:9408 S STEVEN TRL
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:AZ
Practice Address - Zip Code:86332-5041
Practice Address - Country:US
Practice Address - Phone:623-224-3561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZL166079163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant