| Doctor Name: | SUSAN FLANNIGAN |
| NPI Number: | 1659354793 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RNCNP |
| License Number: | R 066120-3 |
| Business Practice Address: | Fairview Lakes Chisago Clinic 11725 Stinson Ave Chisago City, MN - 550139540 |
| Business Phone Number: | 6512578499 |
| Business Fax Number: | |
| Mailing Address: | 25323 Pigeon Loft Rd Ne, STACY |
| State: | MN |
| Postal Code: | 550793161 |
| Phone Number: | 6514620231 |
| Fax Number: | |
| NPI Enumeration Date: | 11/22/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | R 066120-3 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |