Healthcare Provider Details

I. General information

NPI: 1932461670
Provider Name (Legal Business Name): SILKE LYNN FLYNN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2012
Last Update Date: 06/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 E 19TH ST STE 1
CHEYENNE WY
82001-4946
US

IV. Provider business mailing address

1616 E 19TH ST STE 1
CHEYENNE WY
82001-4946
US

V. Phone/Fax

Practice location:
  • Phone: 307-631-9551
  • Fax:
Mailing address:
  • Phone: 307-631-9551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: