Provider Demographics
NPI:1275031973
Name:FLORES, HEATHER LYNETTE (NP)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LYNETTE
Last Name:FLORES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:688 WADE RD SE
Mailing Address - Street 2:
Mailing Address - City:OWENS CROSS ROADS
Mailing Address - State:AL
Mailing Address - Zip Code:35763-9120
Mailing Address - Country:US
Mailing Address - Phone:719-235-1257
Mailing Address - Fax:
Practice Address - Street 1:401 MERIDIAN ST N
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4720
Practice Address - Country:US
Practice Address - Phone:256-372-5601
Practice Address - Fax:256-372-5599
Is Sole Proprietor?:No
Enumeration Date:2018-01-28
Last Update Date:2018-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-148004363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily