Provider Demographics
NPI:1255214086
Name:FLANNERY, DINA LEE I
Entity type:Individual
Prefix:MS
First Name:DINA
Middle Name:LEE
Last Name:FLANNERY
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3233 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53140-2113
Mailing Address - Country:US
Mailing Address - Phone:262-945-0901
Mailing Address - Fax:
Practice Address - Street 1:3233 25TH AVE
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53140-2113
Practice Address - Country:US
Practice Address - Phone:262-945-0901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care