Provider Demographics
NPI:1366496945
Name:FLORES-BYRNE, LIZBETH C (RN, NP)
Entity Type:Individual
Prefix:
First Name:LIZBETH
Middle Name:C
Last Name:FLORES-BYRNE
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:LIZBETH
Other - Middle Name:C
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:300 PASTEUR DR
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94305-2200
Mailing Address - Country:US
Mailing Address - Phone:650-498-5710
Mailing Address - Fax:
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:H-3630
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-498-6022
Practice Address - Fax:650-725-0533
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP10094363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN450588Medicaid
CAP66900Medicare UPIN
CAZZZ24143ZMedicare PIN