Provider Demographics
NPI:1629676044
Name:FLORES, DORALIA YANELY (FNP)
Entity Type:Individual
Prefix:
First Name:DORALIA
Middle Name:YANELY
Last Name:FLORES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 E 22ND ST STE 100
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-2639
Mailing Address - Country:US
Mailing Address - Phone:402-727-7979
Mailing Address - Fax:402-727-9306
Practice Address - Street 1:410 E 22ND ST STE 1
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-2640
Practice Address - Country:US
Practice Address - Phone:402-727-7979
Practice Address - Fax:402-727-9306
Is Sole Proprietor?:No
Enumeration Date:2020-10-16
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142984207Q00000X
NE113720363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine