Healthcare Provider Details

I. General information

NPI: 1013838564
Provider Name (Legal Business Name): BRIANNA NICOLE FLEMING DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E HIBISCUS BLVD
MELBOURNE FL
32901-3102
US

IV. Provider business mailing address

1900 HOWELL LN
MALABAR FL
32950-7017
US

V. Phone/Fax

Practice location:
  • Phone: 321-768-3655
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11049397
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: