Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 26NJ00025900 | NJ |
NPI | 1033188404 |
---|---|
Provider Name | Mrs. Maribett Flores |
First Address | Jackson, NJ 08527-2879 |
Second Address | Brick, NJ 08724-3502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 08/07/2007 |