Provider Demographics
NPI:1801861471
Name:FLANAGAN, PAULA (GNP)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605
Mailing Address - Country:US
Mailing Address - Phone:508-595-2000
Mailing Address - Fax:508-853-7149
Practice Address - Street 1:530 PLANTATION ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605
Practice Address - Country:US
Practice Address - Phone:508-595-2000
Practice Address - Fax:508-853-7149
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA197918363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
381315OtherMVP HEALTH CARE
8300352OtherEVERCARE
NP2108OtherBLUE SHIELD HMO BLUE
04247226OtherONE HEALTH PLAN
NP2108OtherMEDICARE B
042472266OtherTHREE RIVERS
500009934OtherRAILROAD MEDICARE
AA3665OtherHARVARD PILGRIM HEALTHCAR
MA0325201Medicaid
0325201OtherMEDICAID WELFARE
042472266OtherPRIVATE HEALTHCARE SYSTEM
57695OtherFALLON COMMUNITY HEALTH P
NP2108OtherBLUE CARE ELECT
NP2108OtherBLUE SHIELD INDEMNITY
NP2108OtherMEDICARE B
8300352OtherEVERCARE