Provider Demographics
NPI:1821383076
Name:FLANAGAN RAYMOND, BEVERLEY (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLEY
Middle Name:
Last Name:FLANAGAN RAYMOND
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:354 MOUNTAIN VIEW DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-5968
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:354 MOUNTAIN VIEW DR
Practice Address - Street 2:SUITE 300
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-5968
Practice Address - Country:US
Practice Address - Phone:802-857-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0025566363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health