Provider Demographics
NPI:1043424930
Name:FLYNN, ELIZABETH ANN (MS, APRN, BC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:FLYNN
Suffix:
Gender:F
Credentials:MS, APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2911 HERRING AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76708-3245
Mailing Address - Country:US
Mailing Address - Phone:254-755-4559
Mailing Address - Fax:254-755-4549
Practice Address - Street 1:2911 HERRING AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-3245
Practice Address - Country:US
Practice Address - Phone:254-755-4559
Practice Address - Fax:254-755-4549
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX431613363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology