Provider Demographics
NPI:1164399846
Name:LEWARK FLYNN, JENNY (FNP-BC)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:LEWARK FLYNN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2228 WINSTON RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-2110
Mailing Address - Country:US
Mailing Address - Phone:231-649-2152
Mailing Address - Fax:
Practice Address - Street 1:2228 WINSTON RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-2110
Practice Address - Country:US
Practice Address - Phone:231-649-2152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-20
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1001161207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine