Healthcare Provider Details

I. General information

NPI: 1376542001
Provider Name (Legal Business Name): RAMONA K. FLIGHTNER MSN, CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 04/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 GOVE ST
EAST BOSTON MA
02128-1920
US

IV. Provider business mailing address

875 WYOMING ST # A202
MISSOULA MT
59801-1787
US

V. Phone/Fax

Practice location:
  • Phone: 617-569-5800
  • Fax: 617-568-4780
Mailing address:
  • Phone: 857-366-0656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0000339
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number271323
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number101017
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: