Individual
MOIRA SUZANNE FLYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
619 19TH STREET SOUTH, BIRMINGHAM, AL 35233
(205) 934-6600
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
1054620
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009930725
—
AL
01
—
051514166
BLUE CROSS
AL
05
—
051514166
—
AL
01
—
051517788
BLUE CROSS
AL
01
—
500030457
RAILROAD MEDICARE
AL
Enumeration date
07/24/2006
Last updated
07/23/2009
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