Provider Demographics
NPI:1972257483
Name:FLYNN, ASHLIE TARESSA (DNP, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:ASHLIE
Middle Name:TARESSA
Last Name:FLYNN
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:576 E HIGHWAY 138 STE 310
Mailing Address - Street 2:
Mailing Address - City:STANSBURY PARK
Mailing Address - State:UT
Mailing Address - Zip Code:84074-4028
Mailing Address - Country:US
Mailing Address - Phone:801-827-0662
Mailing Address - Fax:801-827-0663
Practice Address - Street 1:576 E HIGHWAY 138 STE 310
Practice Address - Street 2:
Practice Address - City:STANSBURY PARK
Practice Address - State:UT
Practice Address - Zip Code:84074-4028
Practice Address - Country:US
Practice Address - Phone:801-827-0662
Practice Address - Fax:801-827-0663
Is Sole Proprietor?:No
Enumeration Date:2022-02-04
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8994021-3102163W00000X
UT8994021-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse