Healthcare Provider Details

I. General information

NPI: 1467493650
Provider Name (Legal Business Name): NANCY A FLINN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 CURVE CREST BLVD W
STILLWATER MN
55082-6070
US

IV. Provider business mailing address

1460 CURVE CREST BLVD W
STILLWATER MN
55082-6070
US

V. Phone/Fax

Practice location:
  • Phone: 651-439-8283
  • Fax: 651-439-0576
Mailing address:
  • Phone: 651-439-8283
  • Fax: 651-439-0576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number100155
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: