Healthcare Provider Details

I. General information

NPI: 1790694024
Provider Name (Legal Business Name): FLANNEL PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 S STAPLEY DR STE 120
MESA AZ
85204-6676
US

IV. Provider business mailing address

1910 S STAPLEY DR STE 120
MESA AZ
85204-6676
US

V. Phone/Fax

Practice location:
  • Phone: 619-245-3189
  • Fax:
Mailing address:
  • Phone: 480-269-4431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: FRANCIS GEM LANKFORD
Title or Position: SOLE MEMBER
Credential: PMHNP-BC
Phone: 619-245-3189