Provider Demographics
NPI:1104507193
Name:FLORES, INGRID (DNP, CRNP-PC)
Entity type:Individual
Prefix:DR
First Name:INGRID
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:DNP, CRNP-PC
Other - Prefix:
Other - First Name:INGRID
Other - Middle Name:
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP, CRNP-PC
Mailing Address - Street 1:14813 EASTWAY DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-5604
Mailing Address - Country:US
Mailing Address - Phone:443-333-7881
Mailing Address - Fax:
Practice Address - Street 1:50 W EDMONSTON DR STE 502
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1222
Practice Address - Country:US
Practice Address - Phone:301-284-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR224040363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty