Healthcare Provider Details

I. General information

NPI: 1740146216
Provider Name (Legal Business Name): CRYSTAL FLYNN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2025
Last Update Date: 12/29/2025
Certification Date: 12/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 DIVISION AVE NE FL 2
WASHINGTON DC
20019-5457
US

IV. Provider business mailing address

157 FLEET ST
OXON HILL MD
20745-1586
US

V. Phone/Fax

Practice location:
  • Phone: 240-744-2615
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: