Provider Demographics
NPI:1053520379
Name:FLYNN, DEBORAH J (FNP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:J
Last Name:FLYNN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BERKSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-2710
Mailing Address - Country:US
Mailing Address - Phone:413-443-5082
Mailing Address - Fax:
Practice Address - Street 1:105 THE KNOLLS
Practice Address - Street 2:THOMPSON HEALTH CENTER
Practice Address - City:WILLIAMSTOWN
Practice Address - State:MA
Practice Address - Zip Code:01267
Practice Address - Country:US
Practice Address - Phone:413-597-2206
Practice Address - Fax:413-597-2982
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA165327363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily