Provider Demographics
NPI:1962498659
Name:FLYNN, DAWN M (ARNP)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:M
Last Name:FLYNN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:SHELLY
Other - Middle Name:M
Other - Last Name:FLYNN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CPNP ARNP
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:318-356-1851
Mailing Address - Fax:319-356-4855
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:318-356-1851
Practice Address - Fax:319-356-4855
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAC069419363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0419366Medicaid
S98175Medicare UPIN
IA13476Medicare PIN