Basic Information
| Provider Information | |||||||||
| NPI: | 1154318160 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FLANAGAN | ||||||||
| FirstName: | TERESA | ||||||||
| MiddleName: | GIORDANO | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3400 CIVIC CENTER BLVD | ||||||||
| Address2: | 1ST FLOOR WOOD BLDG DEPARTMENT OF OTOLARYNGOLOGY | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191044306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155903440 | ||||||||
| FaxNumber: | 2155903986 | ||||||||
| Practice Location | |||||||||
| Address1: | 3400 CIVIC CENTER BLVD | ||||||||
| Address2: | 1ST FLOOR WOOD BLDG DEPARTMENT OF OTOLARYNGOLOGY | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191044306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155903440 | ||||||||
| FaxNumber: | 2155903986 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | TP004147N | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.