Healthcare Provider Details

I. General information

NPI: 1760043392
Provider Name (Legal Business Name): NATALIE FLEMING FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2019
Last Update Date: 06/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 STATE ST
MERIDEN CT
06450-3293
US

IV. Provider business mailing address

6 HIGHLAND AVE APT 1A
SOMERVILLE MA
02143-1918
US

V. Phone/Fax

Practice location:
  • Phone: 203-237-2229
  • Fax:
Mailing address:
  • Phone: 603-686-3118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12.008180
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number10.158838
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: