Provider Demographics
NPI:1043594195
Name:HANN, SUSANNAH FLYNN (RN, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:SUSANNAH
Middle Name:FLYNN
Last Name:HANN
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 TERRANE AVE
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-1732
Mailing Address - Country:US
Mailing Address - Phone:774-270-3210
Mailing Address - Fax:
Practice Address - Street 1:20 TERRANE AVE
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-1732
Practice Address - Country:US
Practice Address - Phone:774-270-3210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-07
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10940905163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant