Healthcare Provider Details

I. General information

NPI: 1710063755
Provider Name (Legal Business Name): JANET FLYNN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 08/23/2022
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1207 N SPRING ST
GLADWIN MI
48624
US

IV. Provider business mailing address

801 JOE MANN BLVD STE P-6
MIDLAND MI
48642-8900
US

V. Phone/Fax

Practice location:
  • Phone: 989-426-5590
  • Fax:
Mailing address:
  • Phone: 989-791-2455
  • Fax: 989-791-1392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704126534
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704126534
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: