Healthcare Provider Details

I. General information

NPI: 1053910257
Provider Name (Legal Business Name): LAUREN MICHELE FLYNN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2020
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST
BOSTON MA
02114-2621
US

IV. Provider business mailing address

143 LONGWATER DR
NORWELL MA
02061-1683
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-1721
  • Fax:
Mailing address:
  • Phone: 781-878-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN2330325
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2330325
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: