Healthcare Provider Details

I. General information

NPI: 1407513112
Provider Name (Legal Business Name): RACHEL ELIZABETH FLAVIN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2021
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9716 RIVERSIDE PKWY
TULSA OK
74137-7447
US

IV. Provider business mailing address

24700 US HIGHWAY 285 S
BUENA VISTA CO
81211-7704
US

V. Phone/Fax

Practice location:
  • Phone: 918-528-4897
  • Fax:
Mailing address:
  • Phone: 303-905-5989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0997009-NP
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number226314
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: