Provider Demographics
NPI:1073243259
Name:FLYNN, JENNIFER (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:FLYNN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39911 N RIVER BEND RD
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-4605
Mailing Address - Country:US
Mailing Address - Phone:602-319-1012
Mailing Address - Fax:
Practice Address - Street 1:3655 W ANTHEM WAY
Practice Address - Street 2:
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-0430
Practice Address - Country:US
Practice Address - Phone:623-745-3805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-12
Last Update Date:2022-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS025800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist