Provider Demographics
NPI:1851300990
Name:FLAGLOR, SUSAN (FNP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:FLAGLOR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 E WEISGARBER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2604
Mailing Address - Country:US
Mailing Address - Phone:865-584-4747
Mailing Address - Fax:865-584-1363
Practice Address - Street 1:1404 TUSCULUM BLVD
Practice Address - Street 2:SUITE 2100/2300
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4395
Practice Address - Country:US
Practice Address - Phone:423-639-2161
Practice Address - Fax:423-787-1904
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN5886363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3347649Medicaid
TN3347649Medicare PIN
TN3347649Medicaid
TNS70524Medicare UPIN