Provider Demographics
NPI:1518392513
Name:FLYNN, BERNADETTE (DO)
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:
Last Name:FLYNN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 JERICO RD
Mailing Address - Street 2:
Mailing Address - City:BUCKINGHAM
Mailing Address - State:VA
Mailing Address - Zip Code:23921-2905
Mailing Address - Country:US
Mailing Address - Phone:814-979-1896
Mailing Address - Fax:
Practice Address - Street 1:935 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-2211
Practice Address - Country:US
Practice Address - Phone:434-315-5340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2025-01-14
Deactivation Date:2013-10-17
Deactivation Code:
Reactivation Date:2014-02-26
Provider Licenses
StateLicense IDTaxonomies
PAOS018497207Q00000X
VA0102207215207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine