Healthcare Provider Details

I. General information

NPI: 1427047687
Provider Name (Legal Business Name): MICHELE M FLANAGAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELE M SMITH

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 10/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 E UNIVERSITY DR
TEMPE AZ
85281-5391
US

IV. Provider business mailing address

PO BOX 872104
TEMPE AZ
85287-2104
US

V. Phone/Fax

Practice location:
  • Phone: 480-965-3349
  • Fax: 480-965-8914
Mailing address:
  • Phone: 480-965-3349
  • Fax: 480-965-8914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP2029
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: