MEDICARE: MS. LATANE FLANAGAN PMHNP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0024194194	VA
2	363L00000X	Nurse Practitioner	0024194194	VA

General Provider Information

NPI Number	:	1598528614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LATANE FLANAGAN PMHNP-BC

Provider Business Mailing Address
First Line	:	8334 RAVEN RUN DR
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23111-6556
Country	:	US
Telephone Number	:	804-993-8383
Fax Number	:	804-207-8822

Provider Business Practice Location Address
First Line	:	8334 RAVEN RUN DR
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23111-6556
Country	:	US
Telephone Number	:	804-993-8383
Fax Number	:

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

Provider Enumeration Date	:	02/01/2024
Last Update Date	:	03/02/2026

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