Provider Demographics
NPI:1104459254
Name:FLINKMAN, JERED (FPMHNP)
Entity type:Individual
Prefix:
First Name:JERED
Middle Name:
Last Name:FLINKMAN
Suffix:
Gender:M
Credentials:FPMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 MILL ST SW
Mailing Address - Street 2:
Mailing Address - City:MITCHELLVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50169-7702
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:420 MILL ST SW
Practice Address - Street 2:
Practice Address - City:MITCHELLVILLE
Practice Address - State:IA
Practice Address - Zip Code:50169-7702
Practice Address - Country:US
Practice Address - Phone:515-725-5241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAG156096363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health