Healthcare Provider Details

I. General information

NPI: 1013283241
Provider Name (Legal Business Name): MONICA A FLYNN APRN-NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2012
Last Update Date: 11/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 MONTEBELLO RD
PUEBLO CO
81001-1379
US

IV. Provider business mailing address

18877 COUNTY ROAD 42
AKRON CO
80720-9646
US

V. Phone/Fax

Practice location:
  • Phone: 719-545-2746
  • Fax: 719-584-0110
Mailing address:
  • Phone: 308-627-5560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number118
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: