Provider Demographics
NPI:1447001433
Name:FLORES, ROSA ELENA (NP)
Entity type:Individual
Prefix:MISS
First Name:ROSA
Middle Name:ELENA
Last Name:FLORES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 MAPLE AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:WALLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07057-1211
Mailing Address - Country:US
Mailing Address - Phone:973-830-6949
Mailing Address - Fax:
Practice Address - Street 1:203 MAPLE AVE FL 1
Practice Address - Street 2:
Practice Address - City:WALLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07057-1211
Practice Address - Country:US
Practice Address - Phone:973-830-6949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01395900363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care