MEDICARE: MRS. CHERYL R FLINN PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	435	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	253968	OTHER	NE	MIDLANDS CHOICE
2	39213	OTHER	NE	BCBS

General Provider Information

NPI Number	:	1033327721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHERYL R FLINN PA-C

Provider Business Mailing Address
First Line	:	PO BOX 22359
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68542-2359
Country	:	US
Telephone Number	:	402-730-6870
Fax Number	:	402-420-6464

Provider Business Practice Location Address
First Line	:	6891 A ST
Second Line	:	STE 210
City	:	LINCOLN
State	:	NE
Zip	:	68510-4111
Country	:	US
Telephone Number	:	402-488-9050
Fax Number	:	402-488-9059

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	02/06/2008

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