Provider Demographics
NPI:1184780793
Name:FLORIAN, SYLVIA A (CNP)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:A
Last Name:FLORIAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:SYLVIA
Other - Middle Name:A
Other - Last Name:BROOKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6000 BOND AVE
Mailing Address - Street 2:
Mailing Address - City:EAST SAINT LOUIS
Mailing Address - State:IL
Mailing Address - Zip Code:62207-2328
Mailing Address - Country:US
Mailing Address - Phone:618-332-2740
Mailing Address - Fax:618-332-8755
Practice Address - Street 1:6000 BOND AVE
Practice Address - Street 2:
Practice Address - City:EAST SAINT LOUIS
Practice Address - State:IL
Practice Address - Zip Code:62207-2328
Practice Address - Country:US
Practice Address - Phone:618-332-2740
Practice Address - Fax:618-332-8755
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041285806163W00000X
MO064549163W00000X, 363L00000X
IL209001652363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse