Provider Demographics
NPI:1790088995
Name:FLYNN-FORTE, NANCY M
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:M
Last Name:FLYNN-FORTE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:NANCY
Other - Middle Name:M
Other - Last Name:FLYNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:585 NORMANDY VLG
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-6903
Mailing Address - Country:US
Mailing Address - Phone:845-821-0015
Mailing Address - Fax:
Practice Address - Street 1:585 NORMANDY VLG
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-6903
Practice Address - Country:US
Practice Address - Phone:845-821-0015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY380935-1163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health