Provider Demographics
NPI:1447958004
Name:FLOREZ INTEGRATED PSYCHIATRIC SERVICES LLC
Entity type:Organization
Organization Name:FLOREZ INTEGRATED PSYCHIATRIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:GARNELLE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:FLOREZ
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:308-224-1053
Mailing Address - Street 1:PO BOX 164
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68848-0164
Mailing Address - Country:US
Mailing Address - Phone:308-270-0368
Mailing Address - Fax:308-270-0080
Practice Address - Street 1:204 E 25TH ST STE 2
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-4569
Practice Address - Country:US
Practice Address - Phone:308-270-0368
Practice Address - Fax:308-270-0080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-22
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty