Healthcare Provider Details

I. General information

NPI: 1679028930
Provider Name (Legal Business Name): ARLENE FLYNN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2016
Last Update Date: 04/12/2021
Certification Date: 04/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 NICHOLS RD
FITCHBURG MA
01420-1914
US

IV. Provider business mailing address

24-28 NEWTON STREET
SOUTHBOROUGH MA
01772-1215
US

V. Phone/Fax

Practice location:
  • Phone: 978-878-8100
  • Fax:
Mailing address:
  • Phone: 508-460-3219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN01424
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: