Healthcare Provider Details

I. General information

NPI: 1285594119
Provider Name (Legal Business Name): SHERRY L FLYNN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2025
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 W GREEN ST
MARSHALL MI
49068-1423
US

IV. Provider business mailing address

423 W GREEN ST
MARSHALL MI
49068-1423
US

V. Phone/Fax

Practice location:
  • Phone: 269-317-0662
  • Fax:
Mailing address:
  • Phone: 269-317-0662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704148558
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: