Healthcare Provider Details

I. General information

NPI: 1598698540
Provider Name (Legal Business Name): LOREN ELLEN FLEMING RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12800 MISSISSIPPI PKWY STE B200
CROWN POINT IN
46307-6902
US

IV. Provider business mailing address

19832 CLINE ST
LOWELL IN
46356-7113
US

V. Phone/Fax

Practice location:
  • Phone: 219-757-5890
  • Fax:
Mailing address:
  • Phone: 219-902-3360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28266517A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: