Provider Demographics
NPI:1194190652
Name:FLORES, BREANN M (CRM)
Entity type:Individual
Prefix:
First Name:BREANN
Middle Name:M
Last Name:FLORES
Suffix:
Gender:F
Credentials:CRM
Other - Prefix:
Other - First Name:BRREANNA
Other - Middle Name:M
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRM
Mailing Address - Street 1:1435 NE 4TH ST SUITE B
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701
Mailing Address - Country:US
Mailing Address - Phone:541-306-4446
Mailing Address - Fax:541-550-2011
Practice Address - Street 1:1435 NE 4TH ST SUITE B
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701
Practice Address - Country:US
Practice Address - Phone:541-306-4446
Practice Address - Fax:541-550-2011
Is Sole Proprietor?:No
Enumeration Date:2015-12-09
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15-CRM-135175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist