Healthcare Provider Details
I. General information
NPI: 1518392513
Provider Name (Legal Business Name): BERNADETTE FLYNN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/09/2013
Last Update Date: 09/28/2025
Certification Date: 09/28/2025
Deactivation Date: 10/17/2013
Reactivation Date: 02/26/2014
III. Provider practice location address
2515 JERICO RD
BUCKINGHAM VA
23921-2905
US
IV. Provider business mailing address
2515 JERICO RD
BUCKINGHAM VA
23921-2905
US
V. Phone/Fax
- Phone: 814-209-8333
- Fax:
- Phone: 814-979-1896
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | OS018497 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 0102207215 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: