Healthcare Provider Details

I. General information

NPI: 1750476560
Provider Name (Legal Business Name): SARAH EVANS FLYNN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SALLY FLYNN FNP-C

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 08/04/2021
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 S FEDERAL BLVD TAKE CARE CLINIC
DENVER CO
80219-4722
US

IV. Provider business mailing address

1505 S FEDERAL BLVD TAKE CARE CLINIC
DENVER CO
80219-4722
US

V. Phone/Fax

Practice location:
  • Phone: 303-936-0223
  • Fax: 303-936-0227
Mailing address:
  • Phone: 303-936-0223
  • Fax: 303-936-0227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number105365
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number105365
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: