Healthcare Provider Details

I. General information

NPI: 1467644575
Provider Name (Legal Business Name): CAROL CHRISTINE FLANDERS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2007
Last Update Date: 08/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 GATES CIR
BUFFALO NY
14209-1120
US

IV. Provider business mailing address

3 GATES CIR
BUFFALO NY
14209-1120
US

V. Phone/Fax

Practice location:
  • Phone: 716-887-4625
  • Fax: 716-887-4326
Mailing address:
  • Phone: 716-887-4625
  • Fax: 716-887-4326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number333064
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: