Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 76463 | CO |
NPI | 1235359605 |
---|---|
Provider Name | Ms. Therese Ann Flynn |
First Address | Littleton, CO 80127-4318 |
Second Address | Littleton, CO 80122-2602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 08/07/2007 |