Provider Demographics
NPI:1386466365
Name:FLORES, CANDACE ESTHER (APRN-CNP)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:ESTHER
Last Name:FLORES
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:CANDACE
Other - Middle Name:ESTHER
Other - Last Name:OTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 844088
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4088
Mailing Address - Country:US
Mailing Address - Phone:505-609-2258
Mailing Address - Fax:505-609-2259
Practice Address - Street 1:4251 ENGLISH RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87402-1116
Practice Address - Country:US
Practice Address - Phone:505-609-6610
Practice Address - Fax:505-599-4670
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM81531363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily