Provider Demographics
NPI:1326718818
Name:FLYNN, KRISTEN (NBC-HWC)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:FLYNN
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BROOK LN
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-1206
Mailing Address - Country:US
Mailing Address - Phone:413-446-0099
Mailing Address - Fax:
Practice Address - Street 1:7 BROOK LN
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1206
Practice Address - Country:US
Practice Address - Phone:413-446-0099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAA-3094810