Provider Demographics
NPI:1336405729
Name:FLORES, BERNICE MARIE (RN)
Entity Type:Individual
Prefix:MRS
First Name:BERNICE
Middle Name:MARIE
Last Name:FLORES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:BERNICE FLORES USAG-J
Mailing Address - Street 2:UNIT 45013 BOX 3637
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96338
Mailing Address - Country:US
Mailing Address - Phone:315-263-8625
Mailing Address - Fax:
Practice Address - Street 1:BG CRAWFORD F. SAMS HEALTH CLINIC
Practice Address - Street 2:UNIT 45011
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96343-5011
Practice Address - Country:US
Practice Address - Phone:0118146-407-4128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001203565163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse