Healthcare Provider Details

I. General information

NPI: 1841082641
Provider Name (Legal Business Name): ASHLEY FLYNN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 ERWIN RD
DURHAM NC
27705-4699
US

IV. Provider business mailing address

2304 WISPY GREEN LN
RALEIGH NC
27614-6567
US

V. Phone/Fax

Practice location:
  • Phone: 919-681-6570
  • Fax:
Mailing address:
  • Phone: 919-210-2704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2025029435
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: