Healthcare Provider Details

I. General information

NPI: 1013691724
Provider Name (Legal Business Name): CARRIE ANN FLYNN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2023
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 HOMESTEAD PL
ALTON NH
03809-4913
US

IV. Provider business mailing address

80 ACADEMY DR
WOLFEBORO NH
03894-4115
US

V. Phone/Fax

Practice location:
  • Phone: 603-822-4713
  • Fax: 603-875-0490
Mailing address:
  • Phone: 603-491-5807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number065121-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: