Provider Demographics
NPI:1619619673
Name:FLYNN, ERICA LEE (PMHNP)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:LEE
Last Name:FLYNN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:LEE
Other - Last Name:WALKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:280 MERRIMACK ST STE 141
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1780
Mailing Address - Country:US
Mailing Address - Phone:508-663-3859
Mailing Address - Fax:
Practice Address - Street 1:280 MERRIMACK ST STE 141
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1780
Practice Address - Country:US
Practice Address - Phone:508-663-3859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2264106363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health