Provider Demographics
NPI:1902424088
Name:FLYNN-KISSEL, MONICA (NP-C)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:FLYNN-KISSEL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 WALMART WAY STE F
Mailing Address - Street 2:
Mailing Address - City:DAHLONEGA
Mailing Address - State:GA
Mailing Address - Zip Code:30533-0829
Mailing Address - Country:US
Mailing Address - Phone:404-428-1534
Mailing Address - Fax:
Practice Address - Street 1:400 WALMART WAY STE F
Practice Address - Street 2:
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533-0829
Practice Address - Country:US
Practice Address - Phone:404-428-1534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN259221363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care