Provider Demographics
NPI:1508044504
Name:FLOWERS, PHYLLIS FAY (RN ANP)
Entity Type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:FAY
Last Name:FLOWERS
Suffix:
Gender:F
Credentials:RN ANP
Other - Prefix:
Other - First Name:P
Other - Middle Name:F
Other - Last Name:FLOWERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN RNP MN
Mailing Address - Street 1:2206 S KAEN RD
Mailing Address - Street 2:CLACKAMAS COUNTY JAIL
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-4048
Mailing Address - Country:US
Mailing Address - Phone:503-655-8818
Mailing Address - Fax:503-655-8573
Practice Address - Street 1:2206 S KAEN RD
Practice Address - Street 2:CLACKAMAS COUNTY JAIL
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-4048
Practice Address - Country:US
Practice Address - Phone:503-655-8818
Practice Address - Fax:503-655-8573
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR000035814N3RNPP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner