Provider Demographics
NPI:1285956821
Name:FLYNN, ERIN (APRN)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:FLYNN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2890 MAIN ST
Mailing Address - Street 2:STE 2A
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-4980
Mailing Address - Country:US
Mailing Address - Phone:203-378-3696
Mailing Address - Fax:203-383-7222
Practice Address - Street 1:2890 MAIN ST
Practice Address - Street 2:STE 2A
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-4980
Practice Address - Country:US
Practice Address - Phone:203-378-3696
Practice Address - Fax:203-383-7222
Is Sole Proprietor?:No
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004305363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner