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NPI Code Detail

MEDICARE: JILL FLYNN

MEDICARE: JILL FLYNN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCSW1218CNV

General Provider Information

NPI Number : 1023186905
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL FLYNN
Provider Business Mailing Address
First Line : 7375 PRAIRIE FALCON #160
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-3310
Country : US
Telephone Number : 702-233-3000
Fax Number : 702-256-1310
Provider Business Practice Location Address
First Line : 7375 PRAIRIE FALCON RD STE 160
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0818
Country : US
Telephone Number : 702-233-3000
Fax Number : 702-256-1310
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2006
Last Update Date : 07/08/2007

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Directions to “ JILL FLYNN ” Practice Location

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