Provider Demographics
NPI:1578688412
Name:FLANAGAN, TERRENCE F (APRN, BC, FNP)
Entity Type:Individual
Prefix:
First Name:TERRENCE
Middle Name:F
Last Name:FLANAGAN
Suffix:
Gender:M
Credentials:APRN, BC, FNP
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 19
Mailing Address - Street 2:
Mailing Address - City:HERMANN
Mailing Address - State:MO
Mailing Address - Zip Code:65041-0019
Mailing Address - Country:US
Mailing Address - Phone:573-486-1193
Mailing Address - Fax:573-486-0910
Practice Address - Street 1:600 W MORRISON ST
Practice Address - Street 2:SUITE 5
Practice Address - City:FAYETTE
Practice Address - State:MO
Practice Address - Zip Code:65248-1075
Practice Address - Country:US
Practice Address - Phone:660-248-2900
Practice Address - Fax:660-248-1544
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101848363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily