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NPI Code Detail

MEDICARE: MS. TALISYN JESSICA FLAGG CNM

MEDICARE: MS. TALISYN JESSICA FLAGG CNM
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
1363LW0102XWomen's Health Nurse PractitionerF155090IA
2363LW0102XWomen's Health Nurse Practitioner112886NE
3363LW0102XWomen's Health Nurse PractitionerCP001223SD
4363LW0102XWomen's Health Nurse PractitionerR444428ND
5363LW0102XWomen's Health Nurse Practitioner3291MN
6367A00000XAdvanced Practice Midwife213MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457334971
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TALISYN JESSICA FLAGG CNM
Provider Business Mailing Address
First Line : 671 VANDALIA ST
Second Line :
City : SAINT PAUL
State : MN
Zip : 55114-1312
Country : US
Telephone Number : 800-268-9150
Fax Number : 651-696-5543
Provider Business Practice Location Address
First Line : 671 VANDALIA ST
Second Line :
City : SAINT PAUL
State : MN
Zip : 55114-1312
Country : US
Telephone Number : 800-268-9150
Fax Number : 651-696-5543
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2005
Last Update Date : 03/13/2023

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