Provider Demographics
NPI:1386893154
Name:FLYNN, TIMOTHY MICHAEL PATRICK (FNP)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:MICHAEL PATRICK
Last Name:FLYNN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1400 CONGRESS AVE
Mailing Address - Street 2:SUITE E1.214
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-1932
Mailing Address - Country:US
Mailing Address - Phone:512-463-0313
Mailing Address - Fax:512-463-6237
Practice Address - Street 1:1400 CONGRESS AVE
Practice Address - Street 2:SUITE E1.214
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1932
Practice Address - Country:US
Practice Address - Phone:512-463-0313
Practice Address - Fax:512-463-6237
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX521808363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily