Provider Demographics
NPI:1598041519
Name:FLYNN, MEGAN ELIZABETH (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:FLYNN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3110 CHASKA BLVD
Mailing Address - Street 2:
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-2275
Mailing Address - Country:US
Mailing Address - Phone:952-448-1180
Mailing Address - Fax:952-448-1176
Practice Address - Street 1:3110 CHASKA BLVD
Practice Address - Street 2:
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-2275
Practice Address - Country:US
Practice Address - Phone:952-448-1180
Practice Address - Fax:952-448-1176
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNMN117563183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist