Healthcare Provider Details

I. General information

NPI: 1174937197
Provider Name (Legal Business Name): ALISON M FLYNN ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2014
Last Update Date: 09/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 NORTH STREET SUITE 1
PITTSFIELD MA
01201
US

IV. Provider business mailing address

P.O. BOX 30
GREAT BARRINGTON MA
01230
US

V. Phone/Fax

Practice location:
  • Phone: 413-447-2351
  • Fax: 413-445-7009
Mailing address:
  • Phone: 413-528-9311
  • Fax: 413-644-0274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN257614
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: