Provider Demographics
NPI:1477150100
Name:FLYNN, JENNIFER (ND)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:FLYNN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:GARNSWORTHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30 CONGRESS ST STE 202
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:VT
Mailing Address - Zip Code:05478-1745
Mailing Address - Country:US
Mailing Address - Phone:802-391-0560
Mailing Address - Fax:
Practice Address - Street 1:30 CONGRESS ST STE 202
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-1745
Practice Address - Country:US
Practice Address - Phone:802-391-0560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT099.0134127175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath