Individual
BETHANY SHAFFER FLINCHUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10880 DURANT RD, RALEIGH, NC 27614-6629
(919) 235-6509
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-0351
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
0010-10527
NC
363A00000X
Physician Assistant
Primary
0010-10527
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871121269
—
NC
Enumeration date
03/31/2020
Last updated
03/04/2025
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