Provider Demographics
NPI:1831792696
Name:FLORES, AMADA EVELYN (FNP)
Entity type:Individual
Prefix:MS
First Name:AMADA
Middle Name:EVELYN
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 1:4310 S WESTERN ST UNIT E
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-6036
Mailing Address - Country:US
Mailing Address - Phone:806-418-2191
Mailing Address - Fax:
Practice Address - Street 1:4310 S WESTERN ST UNIT E
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-6036
Practice Address - Country:US
Practice Address - Phone:806-418-2191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1018932363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily