Healthcare Provider Details

I. General information

NPI: 1063389070
Provider Name (Legal Business Name): JAYME FLANAGAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2025
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4114 MEDICAL DR APT 6205
SAN ANTONIO TX
78229-5649
US

IV. Provider business mailing address

4114 MEDICAL DR APT 6205
SAN ANTONIO TX
78229-5649
US

V. Phone/Fax

Practice location:
  • Phone: 440-539-4283
  • Fax:
Mailing address:
  • Phone: 440-539-4283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0500X
TaxonomyHemodialysis Registered Nurse
License Number1189710
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: