DR. OCTAVIA LYNNE FLANAGAN


Address: 2151 Century Ln, Johnson City, TN 37604-4469
Phone: 4239262500

DR. OCTAVIA LYNNE FLANAGAN (NPI# 1083045074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1083045074
Entity Type Individual
Full Name DR. OCTAVIA LYNNE FLANAGAN
Other Name MISS OCTAVIA LYNNE BLACKWELDER
Credential RN, PHD
Practice Address 2151 Century Ln
Johnson City
TN 37604-4469
Mailing Address 571 Saint Josephs Blvd
Fl 2
Elmira
NY 14901-3230
Practice Telephone 4239262500
Practice Fax Number 4239265999
Mailing Telephone 6072712050
Enumeration Date 2013-12-02
Last Update Date 2019-09-13
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LW0102X Nurse Practitioner
Specialization: Women's Health
20056 TN Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
TN Q016313 05

Office Location

Street Address 2151 CENTURY LN
City JOHNSON CITY
State TN
Zip Code 37604-4469

Providers in the same location

NPI Name Taxonomy Address Enumeration
1245238914 Rebecca A Morrison Nurse Practitioner 2151 Century Ln, Johnson City, TN 37604-4469 2005-07-07
1275169187 Sudha Raj Kumar Nurse Practitioner 2151 Century Ln, Johnson City, TN 37604-4469 2020-03-23
1710522636 Natalie Grace Wigle Social Worker 2151 Century Ln, Johnson City, TN 37604-4469 2019-11-14
1093281297 Ernest David Maupin Nurse Practitioner 2151 Century Ln, Johnson City, TN 37604-4469 2018-10-16
1124593132 East Tennessee State University Social Worker 2151 Century Ln, Johnson City, TN 37604-4469 2018-10-05
1760923536 Tonja Schnelle Nurse Practitioner 2151 Century Ln, Johnson City, TN 37604-4469 2017-03-14
1477009215 Amanda York Social Worker 2151 Century Ln, Johnson City, TN 37604-4469 2016-08-31
1770933186 Sarah S Carlisle Dentist 2151 Century Ln, Johnson City, TN 37604-4469 2016-06-16
1154780716 East Tennessee State University Pharmacy 2151 Century Ln, Johnson City, TN 37604-4469 2016-02-11
1831554575 Paige R Mullins Nurse Practitioner 2151 Century Ln, Johnson City, TN 37604-4469 2015-12-23
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1417560707 Brant Logan Nickens Physical Therapist 809 Lamont St and Veterans Way, Johnson City, TN 37604 2020-08-26
1952911562 David Sandlin Hobbs Pharmacist Lamont St &, Veterans Way, Johnson City, Tn 37604, Johnson City, TN 37604 2020-08-07
1528688272 Whitney Marie Ward Physical Therapist Lamont Street and Veterans Way, Johnson City, TN 37604 2020-04-23
1861050015 Akesh Thomas Student in an Organized Health Care Education/Training Program Johnson City Medical Center, 400 N State of Franklin Rd, Johnson City, TN 37604 2019-06-03
1336629021 Medical Education Assistance Corporation Clinic/Center 820 W Market St, Johnson City, TN 37604 2018-08-21
1093208951 Lauren Tiffany Hayden Physician Assistant 403 N State of Franklin Rd Woodridge Hospital, Johnson City, TN 37604 2018-06-14
1174014450 Jerica Moore Specialist/Technologist 1041 Hamiltion Place Dr., Johnson City, TN 37604 2018-05-23
1053809442 Syed Ghazanfar Hasan Student in an Organized Health Care Education/Training Program Etsu Psychiatry and Behavioral Sciences Department, 1276 Gilbreath Dr., Johnson City, TN 37604 2018-05-01
1699262485 Sonia Kumari Oad Student in an Organized Health Care Education/Training Program 178 West Maple St, Johnson City, TN 37604 2018-04-17
1821519364 Mahmoud El Iskandarani Internal Medicine 1084 W Oakland Avenue, 748, Johnson City, TN 37604 2017-07-06
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Taxonomy Information

Taxonomy Code 363LW0102X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Women's Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1912438706 Jennifer L. Stire Nurse Practitioner 1319 Sunset Dr Ste 103, Johnson City, TN 37604-7901 2017-03-23
1013462407 Ariel Denton Nurse Practitioner 301 Med Tech Pkwy, Suite 200, Johnson City, TN 37604-2364 2016-08-16
1194119404 Anna K. Justice Nurse Practitioner 325 N State of Franklin Rd Fl 1, Johnson City, TN 37604-6056 2015-03-25
1801161021 Jana C Flynn Nurse Practitioner 1319 Sunset Dr, Suite 103, Johnson City, TN 37604-3799 2012-03-21
1679841357 Charlene Marie Greer Nurse Practitioner 33-57 Harrison Street, Johnson City, NY 13790-2558 2011-12-08
1568502706 Iris Gaynell Norman Nurse Practitioner 415 N State of Franklin Rd, Johnson City, TN 37604-6034 2007-02-07
1477585818 Sadie P. Hutson Nurse Practitioner 807 University Pkwy, Nicks Hall, Room 160, Johnson City, TN 37614-6500 2006-07-07

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1144839648 Tasha Yarris Nurse Practitioner 412 Dr D.b. Todd Jr Blvd., Nashville, TN 37203 2020-07-30
1073143756 Tailar Murphy Nurse Practitioner 2004 Hayes St Ste 310, Nashville, TN 37203-2653 2020-01-22
1528616687 Melanie Hall Morris Nurse Practitioner 1120 Arrowhead Dr, Brentwood, TN 37027-7475 2019-08-30
1053884833 E. Lauren Mclean, Apn, LLC Nurse Practitioner 300 Stonecrest Blvd Ste 250, Smyrna, TN 37167-6832 2019-01-04
1548719313 Lauren Michelle Grude Nurse Practitioner 7106 Sugar Maple Dr, Fairview, TN 37062-9338 2016-09-22
1760852198 Mitna Ngo Nurse Practitioner 2201 Murphy Ave Ste 308, Nashville, TN 37203-1960 2015-09-28
1720455629 Catherine Jaynes Mukherji Nurse Practitioner 6 Castlewood Ct, Nashville, TN 37215-4617 2015-08-26
1740678986 Melanie Sophia Krishnamurthy Nurse Practitioner 4323 Carothers Pkwy Ste 208, Franklin, TN 37067-5916 2014-12-22
1124441928 Marsha Sanderson Nurse Practitioner 529 Williamsburg Dr, Atoka, TN 38004-7893 2014-01-29
1255696126 Diary L. Prater Nurse Practitioner 4976 Gardenwood Dr, Memphis, TN 38116-7916 2012-07-06
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Competitor

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City JOHNSON CITY
Zip Code 37604

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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