Healthcare Provider Details

I. General information

NPI: 1811931553
Provider Name (Legal Business Name): ELIZABETH D. FLYNN HEITMAN A.P.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH DARBY FLYNN HEITMAN NP

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7945 WOLF RIVER BLVD
GERMANTOWN TN
38138-1762
US

IV. Provider business mailing address

7714 POPLAR AVE STE 200
GERMANTOWN TN
38138-3941
US

V. Phone/Fax

Practice location:
  • Phone: 901-683-0055
  • Fax: 901-685-2969
Mailing address:
  • Phone: 901-683-0055
  • Fax: 901-922-6722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number905305
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: