Healthcare Provider Details

I. General information

NPI: 1366164287
Provider Name (Legal Business Name): JOYCE FLYNT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2022
Last Update Date: 09/16/2022
Certification Date: 09/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1630 MAIN ST STE 101
CHESTER MD
21619-2792
US

IV. Provider business mailing address

13 WILLOW CT
STEVENSVILLE MD
21666-2222
US

V. Phone/Fax

Practice location:
  • Phone: 410-604-6560
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95014366
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: