Provider Demographics
NPI:1245917616
Name:FLYNN, ISABELLA ELLEN
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:ELLEN
Last Name:FLYNN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4607 CONWAY CT
Mailing Address - Street 2:
Mailing Address - City:OLD HICKORY
Mailing Address - State:TN
Mailing Address - Zip Code:37138-4271
Mailing Address - Country:US
Mailing Address - Phone:931-349-2904
Mailing Address - Fax:
Practice Address - Street 1:4607 CONWAY CT
Practice Address - Street 2:
Practice Address - City:OLD HICKORY
Practice Address - State:TN
Practice Address - Zip Code:37138-4271
Practice Address - Country:US
Practice Address - Phone:931-349-2904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider