Provider Demographics
NPI:1891589966
Name:FLYNN, OWEN FRANCIS
Entity type:Individual
Prefix:
First Name:OWEN
Middle Name:FRANCIS
Last Name:FLYNN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 RICHMOND CIR
Mailing Address - Street 2:
Mailing Address - City:CHITTENANGO
Mailing Address - State:NY
Mailing Address - Zip Code:13037-9442
Mailing Address - Country:US
Mailing Address - Phone:315-383-9484
Mailing Address - Fax:
Practice Address - Street 1:109 GENESEE ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-2703
Practice Address - Country:US
Practice Address - Phone:315-231-5530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-05
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF04240025363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily