Healthcare Provider Details

I. General information

NPI: 1033327721
Provider Name (Legal Business Name): CHERYL R FLINN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 02/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6891 A ST STE 210
LINCOLN NE
68510-4111
US

IV. Provider business mailing address

PO BOX 22359
LINCOLN NE
68542-2359
US

V. Phone/Fax

Practice location:
  • Phone: 402-488-9050
  • Fax: 402-488-9059
Mailing address:
  • Phone: 402-730-6870
  • Fax: 402-420-6464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number435
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: