National Provider Identifier
Octavia Lynne Flanagan, RN, PHD
Octavia Lynne Flanagan, RN, PHD is listed in the NPPES registry with a primary specialty of Women's Health Nurse Practitioner in Elmira, NY and a listed phone number of (607) 734-6544.
Profile Overview
- NPI
- 1083045074
- Provider Type
- Individual
- Primary Specialty
- Women's Health Nurse Practitioner
- Enumeration Date
- December 02, 2013
- Last Updated
- November 24, 2020
Practice Location
- 600 Fitch St Ste 102
- Elmira, NY 14905-1634
Phone: (607) 734-6544
Mailing Address
- 571 Saint Josephs Blvd
- Fl 2
- Elmira, NY 14901-3230
Specialties
- Women's Health Nurse Practitioner (363LW0102X)
Full Record
- NPI
- 1083045074
- Entity Type
- Individual
- Last Name
- Flanagan
- First Name
- Octavia
- Middle Name
- Lynne
- Credential
- RN, PHD
- Provider Other Last Name
- Blackwelder
- Provider Other First Name
- Octavia
- Provider Other Middle Name
- Lynne
- Provider Other Name Prefix Text
- Miss
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 571 Saint Josephs Blvd
- Mailing Address Line 2
- Fl 2
- Mailing City
- Elmira
- Mailing State
- NY
- Mailing ZIP Code
- 14901-3230
- Mailing Country
- US
- Mailing Phone
- (607) 271-2050
- Practice Street Address
- 600 Fitch St Ste 102
- Practice City
- Elmira
- Practice State
- NY
- Practice ZIP Code
- 14905-1634
- Practice Country
- US
- Practice Phone
- (607) 734-6544
- Practice Fax
- (607) 734-6580
- Enumeration Date
- December 02, 2013
- Last Updated
- November 24, 2020
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- November 24, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Women's Health Nurse Practitioner (363LW0102X)
- Other Identifiers
- Q016313 (TN), 05623143 (NY)