Provider Demographics
NPI:1639753460
Name:FLYNN, NANCY PATTERSON (MS, ATC, CSCS)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:PATTERSON
Last Name:FLYNN
Suffix:
Gender:F
Credentials:MS, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 HUNTLEY HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63021-5884
Mailing Address - Country:US
Mailing Address - Phone:636-686-5278
Mailing Address - Fax:914-509-5409
Practice Address - Street 1:541 HUNTLEY HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63021-5884
Practice Address - Country:US
Practice Address - Phone:636-686-5278
Practice Address - Fax:914-509-5409
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20160381862255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer