Provider Demographics
NPI:1386642437
Name:FISCHER-FLORES, LUZ ENEIDA (MSN, APRN,ANP,BC)
Entity Type:Individual
Prefix:MRS
First Name:LUZ
Middle Name:ENEIDA
Last Name:FISCHER-FLORES
Suffix:
Gender:F
Credentials:MSN, APRN,ANP,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 JAMESTOWN CT
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-3923
Mailing Address - Country:US
Mailing Address - Phone:860-659-3865
Mailing Address - Fax:
Practice Address - Street 1:200 EXECUTIVE BLVD
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-1058
Practice Address - Country:US
Practice Address - Phone:860-296-2790
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001810363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health