Healthcare Provider Details

I. General information

NPI: 1578637922
Provider Name (Legal Business Name): DEBORAH FLINT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SOUTH ST
CHESTNUT HILL MA
02467-3658
US

IV. Provider business mailing address

PO BOX 230368
BOSTON MA
02123-0368
US

V. Phone/Fax

Practice location:
  • Phone: 617-469-0300
  • Fax:
Mailing address:
  • Phone: 617-325-3041
  • Fax: 617-325-1503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number213515
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: