Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 185267 | NC |
NPI | 1235517830 |
---|---|
Provider Name | Andrea Flynn |
First Address | Hickory, NC 28602-9617 |
Second Address | Hickory, NC 28602-9617 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2015 |
Last Update Date | 14/05/2015 |