Provider Demographics
NPI:1558631986
Name:FLANNERY, ELIZABETH (RN)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:FLANNERY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19797
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30325-0797
Mailing Address - Country:US
Mailing Address - Phone:404-587-7112
Mailing Address - Fax:
Practice Address - Street 1:500 NORTHSIDE CIR NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-2122
Practice Address - Country:US
Practice Address - Phone:404-587-7112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-02
Last Update Date:2012-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN138697163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical