Provider Demographics
NPI:1659628238
Name:FLANAGAN, CAITLIN (PA-C)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2491 OLEANDER CIR
Mailing Address - Street 2:
Mailing Address - City:JAMISON
Mailing Address - State:PA
Mailing Address - Zip Code:18929-1177
Mailing Address - Country:US
Mailing Address - Phone:215-378-6128
Mailing Address - Fax:
Practice Address - Street 1:1205 LANGHORNE NEWTOWN RD
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1219
Practice Address - Country:US
Practice Address - Phone:215-710-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055667363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant