Provider Demographics
NPI:1043843071
Name:FLYNT, AMANDA N (PHARMD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:N
Last Name:FLYNT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:N
Other - Last Name:BURKERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1911 E REZANOF DR
Mailing Address - Street 2:
Mailing Address - City:KODIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99615-6602
Mailing Address - Country:US
Mailing Address - Phone:907-481-5000
Mailing Address - Fax:907-481-5030
Practice Address - Street 1:1911 E REZANOF DR
Practice Address - Street 2:
Practice Address - City:KODIAK
Practice Address - State:AK
Practice Address - Zip Code:99615-6602
Practice Address - Country:US
Practice Address - Phone:907-481-5000
Practice Address - Fax:907-481-5030
Is Sole Proprietor?:No
Enumeration Date:2020-02-18
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK148329183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist