Basic Information
Provider Information | |||||||||
NPI: | 1184254351 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | FLANAGAN | ||||||||
FirstName: | LINDSAY | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 40 FRONT ST | ||||||||
Address2: |   | ||||||||
City: | BINGHAMTON | ||||||||
State: | NY | ||||||||
PostalCode: | 139054712 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6077227264 | ||||||||
FaxNumber: | 6077227869 | ||||||||
Practice Location | |||||||||
Address1: | 169 RIVERSIDE DR | ||||||||
Address2: |   | ||||||||
City: | BINGHAMTON | ||||||||
State: | NY | ||||||||
PostalCode: | 139054198 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6077985283 | ||||||||
FaxNumber: | 6077295332 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 01/16/2020 | ||||||||
LastUpdateDate: | 08/12/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 08/12/2020 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN705902 | PA | N |   | Nursing Service Providers | Registered Nurse |   | 163W00000X | 649034-01 | NY | N |   | Nursing Service Providers | Registered Nurse |   | 367500000X | 128445 | NY | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |   |
No ID Information.