Healthcare Provider Details

I. General information

NPI: 1861736019
Provider Name (Legal Business Name): JEAN FLYNN MCGEE R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2012
Last Update Date: 11/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5299 SELMA RD
SPRINGFIELD OH
45502-7413
US

IV. Provider business mailing address

5299 SELMA RD
SPRINGFIELD OH
45502-7413
US

V. Phone/Fax

Practice location:
  • Phone: 937-215-3630
  • Fax:
Mailing address:
  • Phone: 937-215-3630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN274420
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: