MEDICARE: MRS. STACI ELIZABETH FLANAGAN MA, CCC-SLP

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	235Z00000X	Speech-Language Pathologist	3596	KS

Other Identifiers

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

General Provider Information

NPI Number	:	1598903346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STACI ELIZABETH FLANAGAN MA, CCC-SLP

Provider Business Mailing Address
First Line	:	13213 W 21ST CT STE 104
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67235-9625
Country	:	US
Telephone Number	:	316-573-6802
Fax Number	:	316-721-2291

Provider Business Practice Location Address
First Line	:	1861 N ROCK RD STE 101
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67206-1264
Country	:	US
Telephone Number	:	316-573-6802
Fax Number	:	316-721-2291

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

Provider Enumeration Date	:	02/02/2009
Last Update Date	:	10/10/2022

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Directions to “ MRS. STACI ELIZABETH FLANAGAN MA, CCC-SLP” Practice Location

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