Provider Demographics
NPI:1114025889
Name:FLYNN, ELIZABETH BAMFORD (ARNP)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:BAMFORD
Last Name:FLYNN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SEVERANCE DR
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3118
Mailing Address - Country:US
Mailing Address - Phone:603-437-1028
Mailing Address - Fax:978-322-5186
Practice Address - Street 1:391 VARNUM AVE
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-2119
Practice Address - Country:US
Practice Address - Phone:978-322-5183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA145223363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health