Healthcare Provider Details

I. General information

NPI: 1811101744
Provider Name (Legal Business Name): JAMIE FLESHER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 01/05/2021
Certification Date: 01/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2531 W MADERO AVE
MESA AZ
85202-6903
US

IV. Provider business mailing address

2531 W MADERO AVE
MESA AZ
85202-6903
US

V. Phone/Fax

Practice location:
  • Phone: 480-227-7591
  • Fax:
Mailing address:
  • Phone: 480-227-7591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN103465
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: