Provider Demographics
NPI:1376126946
Name:FLYNN, CHRISTY (RN)
Entity Type:Individual
Prefix:MS
First Name:CHRISTY
Middle Name:
Last Name:FLYNN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:CHRISTY
Other - Middle Name:M
Other - Last Name:LEONARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CHRISTY M LEONARD
Mailing Address - Street 1:2814 S 108TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53227-3224
Mailing Address - Country:US
Mailing Address - Phone:414-885-3525
Mailing Address - Fax:
Practice Address - Street 1:2814 S 108TH ST
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-3224
Practice Address - Country:US
Practice Address - Phone:414-885-3525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI239552163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI239552OtherRN LICENSE