Healthcare Provider Details

I. General information

NPI: 1235648627
Provider Name (Legal Business Name): ERIN FLYNN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2017
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 PUUMAKANI ST
KAHULUI HI
96732-3147
US

IV. Provider business mailing address

163 PUUMAKANI ST
KAHULUI HI
96732-3147
US

V. Phone/Fax

Practice location:
  • Phone: 646-876-8455
  • Fax:
Mailing address:
  • Phone: 413-262-7575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71007530A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: