Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | F420353 | NY |
NPI | 1033131354 |
---|---|
Provider Name | Kathryn B Flynn |
First Address | Rochester, NY 14642-0001 |
Second Address | Rochester, NY 14642-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 16/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03256815 | (05) | NY |
NP0275 | PREFERRED CARE (01) | NY |
P019420353 | BLUE CHOICE (01) | NY |