Individual
MRS. KATIE SHOE FLYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3382 PARIS BLVD, WESTERVILLE, OH 43081-4260
(614) 882-2521
(614) 882-0511
Mailing address
3382 PARIS BLVD, WESTERVILLE, OH 43081-4260
(614) 882-2521
(614) 882-0511
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.003252RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0089554
—
OH
Enumeration date
06/27/2011
Last updated
08/09/2016
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