Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 0993973 | CO |
NPI | 1013403914 |
---|---|
Provider Name | Erik Alfonso Flores |
First Address | Denver, CO 80212-1832 |
Second Address | Denver, CO 80204 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2018 |
Last Update Date | 25/12/2019 |