Provider Demographics
NPI:1245514678
Name:FLYNN, DONNA E (RNP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:E
Last Name:FLYNN
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 BUCKINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-4417
Mailing Address - Country:US
Mailing Address - Phone:617-698-5415
Mailing Address - Fax:
Practice Address - Street 1:70 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:S WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-2427
Practice Address - Country:US
Practice Address - Phone:781-337-1518
Practice Address - Fax:781-337-6910
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA120970163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NP3008Medicare PIN
P22642Medicare UPIN