Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VX0000X | Obstetrician | RN253760 | MA |
NPI | 1093865750 |
---|---|
Provider Name | Rachel Flynn |
First Address | Boston, MA 02109-4806 |
Second Address | Boston, MA 02109-4806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2007 |
Last Update Date | 13/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0700312 | (05) | MA |
CN0293 | BCBS (01) | MA |