Provider Demographics
NPI:1588024822
Name:FLORES, JERIFAYE BASIGA (APRN, FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:JERIFAYE
Middle Name:BASIGA
Last Name:FLORES
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:MS
Other - First Name:MARIA JERIFAYE
Other - Middle Name:BASIGA
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 35380
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-5380
Mailing Address - Country:US
Mailing Address - Phone:702-579-3272
Mailing Address - Fax:
Practice Address - Street 1:888 S RANCHO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-3810
Practice Address - Country:US
Practice Address - Phone:702-877-8654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-29
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN002153363LP2300X
NVRN62360163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1588024822Medicaid
NVV114725Medicare PIN