Provider Demographics
NPI:1689161291
Name:FLYNN, NOREEN ELIZABETH (PA-C)
Entity Type:Individual
Prefix:
First Name:NOREEN
Middle Name:ELIZABETH
Last Name:FLYNN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:NOREEN
Other - Middle Name:ELIZABETH
Other - Last Name:COSTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 14531
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4038
Mailing Address - Country:US
Mailing Address - Phone:508-672-0545
Mailing Address - Fax:508-672-0547
Practice Address - Street 1:277 PLEASANT ST STE 101
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721
Practice Address - Country:US
Practice Address - Phone:508-672-0545
Practice Address - Fax:508-672-0547
Is Sole Proprietor?:No
Enumeration Date:2018-04-18
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA6471363AS0400X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical