Active NPI
Divina Flamingarrow
- Licensed Practical Nurse
- Mesa, AZ
National Provider Identifier
1629444807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- LP037535
- Practice address
- 1025 N Country Club Dr
Mesa, AZ 85201-3307 - Phone
- (480) 472-0502
- NPI assigned
- Aug 11, 2015
- Last updated
- Aug 11, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LP037535 | AZ | Primary |
Addresses
Primary practice location
1025 N Country Club Dr
Mesa, AZ 85201-3307
Mailing address
960 N Gilbert Rd
Apt 218
Gilbert, AZ 85234-3319
Phone (928) 925-5887
Other names 1
- Gerlyn Anne Boeh
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP037535 | AZ | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439251200000",
"number": "1629444807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "960 N GILBERT RD",
"address_2": "APT 218",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852343319",
"telephone_number": "928-925-5887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 N COUNTRY CLUB DR",
"city": "MESA",
"state": "AZ",
"postal_code": "852013307",
"telephone_number": "480-472-0502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLAMINGARROW",
"first_name": "DIVINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-11",
"last_updated": "2015-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "AZ",
"license": "LP037535",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "GERLYN",
"last_name": "BOEH",
"middle_name": "ANNE",
"credential": "LPN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.