Provider Demographics
NPI:1154526978
Name:FLOWERS, STEPHANIE LATRICIA (CERTIFIED NURSE ASST)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:LATRICIA
Last Name:FLOWERS
Suffix:
Gender:F
Credentials:CERTIFIED NURSE ASST
Other - Prefix:MISS
Other - First Name:STEPHANIE
Other - Middle Name:LATRICIA
Other - Last Name:CRITTEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CERTIFIED NURSE ASST
Mailing Address - Street 1:340 LACOSTA AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32404-2407
Mailing Address - Country:US
Mailing Address - Phone:850-522-0969
Mailing Address - Fax:
Practice Address - Street 1:340 LACOSTA AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32404-2407
Practice Address - Country:US
Practice Address - Phone:850-522-0969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA 127198376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide