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General NPI Number Information
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NPI Number | 1023156874
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Entity Type | Individual
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Provider Name | JANET GAY FLANAGAN PA
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Gender | Female
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 755 53RD AVE NE
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City | FRIDLEY
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State | MN
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Zip | 55421-1240
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Country | US
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Telephone | 763-571-9361
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Fax |
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Provider Business Mailing Address
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Address Line | 1655 HIGHLAND TRL
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City | SAINT CLOUD
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State | MN
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Zip | 56301-9593
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Country | US
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Telephone | 320-230-5855
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 9807
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License Number State | MN
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