Provider Demographics
NPI:1780138651
Name:MULLER-FLYNN, EMILIA A (CNS LDN)
Entity type:Individual
Prefix:
First Name:EMILIA
Middle Name:A
Last Name:MULLER-FLYNN
Suffix:
Gender:F
Credentials:CNS LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23236 OAK HILL LN
Mailing Address - Street 2:
Mailing Address - City:CALIFORNIA
Mailing Address - State:MD
Mailing Address - Zip Code:20619-6108
Mailing Address - Country:US
Mailing Address - Phone:240-298-6801
Mailing Address - Fax:
Practice Address - Street 1:23236 OAK HILL LN
Practice Address - Street 2:
Practice Address - City:CALIFORNIA
Practice Address - State:MD
Practice Address - Zip Code:20619-6108
Practice Address - Country:US
Practice Address - Phone:240-298-6801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX3944133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist