MEDICARE: JANA C FLYNN A.N.P.

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
1	363LW0102X	Women's Health Nurse Practitioner	ANP5995	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801161021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANA C FLYNN A.N.P.

Provider Business Mailing Address
First Line	:	PO BOX 699
Second Line	:
City	:	MOUNTAIN HOME
State	:	TN
Zip	:	37684-0699
Country	:	US
Telephone Number	:	423-439-7272
Fax Number	:	423-439-7235

Provider Business Practice Location Address
First Line	:	1319 SUNSET DR
Second Line	:	SUITE 103
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-3799
Country	:	US
Telephone Number	:	423-439-7246
Fax Number	:	423-282-4698

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2012
Last Update Date	:	10/25/2016

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