Healthcare Provider Details

I. General information

NPI: 1700386877
Provider Name (Legal Business Name): ANNE MARIE FLYNN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNE MARIE LIMBERT

II. Dates (important events)

Enumeration Date: 02/15/2018
Last Update Date: 01/21/2021
Certification Date: 01/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 E APPLE ST SUITE 5254 A
DAYTON OH
45409
US

IV. Provider business mailing address

3170 KETTERING BLVD BLDG B 3RD FLOOR
MORAINE OH
45439-1924
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-4200
  • Fax: 937-208-4205
Mailing address:
  • Phone: 937-991-3188
  • Fax: 937-223-9811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.392209
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.022348
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: