Provider Demographics
NPI:1881230811
Name:FLASK, JOSEPH D III (PMHNP)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:D
Last Name:FLASK
Suffix:III
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 WINTER LN
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44410-1100
Mailing Address - Country:US
Mailing Address - Phone:330-609-4499
Mailing Address - Fax:
Practice Address - Street 1:6935 WOODLANDS LN
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-4664
Practice Address - Country:US
Practice Address - Phone:440-498-8177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-25
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.025994363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health