MRS. KRISTEN E. FLACK (NPI# 1144746140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144746140 |
| Entity Type | Individual |
| Full Name | MRS. KRISTEN E. FLACK |
| Credential | AGNP |
| Practice Address |
1540 Florida Ave Modesto CA 95350-4430 |
| Mailing Address |
1910 Customer Care Way Atwater CA 95301-5167 |
| Practice Telephone | 2092384800 |
| Practice Fax Number | 2092384890 |
| Mailing Telephone | 2093846493 |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2017-09-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN95078988 | CA | Nursing Service Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
NP95007308 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1540 FLORIDA AVE |
| City | MODESTO |
| State | CA |
| Zip Code | 95350-4430 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487608477 | Richard Warren Gratian | Pediatrics | 1540 Florida Ave, Ste 205, Modesto, CA 95350-4430 | 2006-05-22 |
| 1255957221 | Nathan Chalk | Counselor | 1540 Florida Ave, Modesto, CA 95350-4430 | 2020-06-24 |
| 1568009629 | Taneaka Koshko-bradley | Case Manager/Care Coordinator | 1540 Florida Ave, Modesto, CA 95350-4430 | 2019-12-06 |
| 1720630197 | James Dean Stalians | Registered Nurse | 1540 Florida Ave, Modesto, CA 95350-4430 | 2019-07-15 |
| 1225552284 | Dheera Tamvada | Internal Medicine | 1540 Florida Ave, Modesto, CA 95350-4430 | 2017-08-01 |
| 1952602708 | Wendy Zolczynski | Registered Nurse | 1540 Florida Ave, Ste 100, Modesto, CA 95350 | 2010-11-10 |
| 1366760027 | Talwinderdeep Singh Kahlon | Internal Medicine | 1540 Florida Ave, Suite 100, Modesto, CA 95350-4430 | 2010-05-05 |
| 1265767669 | Melissa Ann Sorensen | Registered Nurse | 1540 Florida Ave, Suite 100, Modesto, CA 95350-4430 | 2009-10-02 |
| 1235361536 | Allyson M Van Horn | Registered Nurse | 1540 Florida Ave, Suite 100, Modesto, CA 95350-4430 | 2009-08-20 |
| 1851532261 | Jayshri Mahesh Nimbargi | Internal Medicine | 1540 Florida Ave, Modesto, CA 95350-4430 | 2009-03-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020459 | Karina Montes Rodriguez | Case Manager/Care Coordinator | Cip 1540 Florida Ave, Suite 212, Modesto, CA 95350 | 2020-10-09 |
| 1134737315 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 2057 Tully Road, Suite A, Modesto, CA 95350 | 2020-07-14 |
| 1588211254 | Karla Junuen Toscano | Licensed Vocational Nurse | 1235 Mchenry Ave. Suites A&b, Modesto, CA 95350 | 2019-08-19 |
| 1831694769 | Loretta Myers-weber | Nurse Practitioner | 1510 Florida Ave Ste A, Modesto, CA 95350 | 2018-03-23 |
| 1720599632 | Coral Alejandra Amador | Counselor | 1700 Mchenry Village Way, Suite 11b, Modesto, CA 95350 | 2017-10-18 |
| 1053820522 | Pannu and Henne Dental Corp. | Dentist | 3219 Mc Henry Ave, Suite E, Modesto, CA 95350 | 2017-09-27 |
| 1346779709 | Kevin Sotelo | Behavior Technician | 2630 W Rumble Road, Modesto, CA 95350 | 2017-06-08 |
| 1255869566 | Hoa Xuan Phan | Family Medicine | 1441 Florida Ave Ste 200, Modesto, CA 95350 | 2017-05-31 |
| 1356881163 | Brady S Marshall | Dentist | 201 E. Orangeburg Avenue, Suite C, Modesto, CA 95350 | 2017-02-27 |
| 1750755476 | Caremore Health Plan | Nurse Practitioner | 1234 Mchenry Avenue, Modesto, CA 95350 | 2015-11-18 |
| Find all providers in zip 95350 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174139109 | Lena Kazanchyan | Nurse Practitioner | 11834 Archwood St, North Hollywood, CA 91606-1603 | 2020-09-16 |
| 1740898386 | Victor De Guzman | Nurse Practitioner | 24808 Sand Wedge Ln, Valencia, CA 91355-2315 | 2020-07-20 |
| 1114535937 | Ashley Elizabeth Rosso | Nurse Practitioner | 3111 Camino Del Rio N Ste 625, San Diego, CA 92108-5718 | 2020-07-17 |
| 1518586452 | Zaruhi Harutyunyan | Nurse Practitioner | 7901 Santa Monica Blvd Ste 206, West Hollywood, CA 90046-5180 | 2020-04-10 |
| 1457986168 | Maritza J Lira | Nurse Practitioner | 23141 Verdugo Dr Ste 201, Laguna Hills, CA 92653-1341 | 2020-03-03 |
| 1225677198 | Shannon Ha Duyen Sicat | Nurse Practitioner | 2617 E Chapman Ave Ste 109, Orange, CA 92869-3245 | 2019-12-24 |
| 1528605961 | Elsa L Pineda-flores | Nurse Practitioner | 1513 S Grand Ave Ste 306, Los Angeles, CA 90015-3075 | 2019-12-04 |
| 1447895073 | Kemi Osilesi | Nurse Practitioner | 1943 Seasons St, Simi Valley, CA 93065-0580 | 2019-11-07 |
| 1487297107 | Fareeha Sipra | Nurse Practitioner | Fresno County Jail, 1225 M Street, Fresno, CA 93721 | 2019-10-25 |
| 1255993531 | May Therese Ronci | Nurse Practitioner | 38504 Cougar Pass, Palmdale, CA 93551-5019 | 2019-07-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.