Healthcare Provider Details

I. General information

NPI: 1508814013
Provider Name (Legal Business Name): BRIAN FLEEMAN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 N WALDRON ST STE 2
HUTCHINSON KS
67502-1176
US

IV. Provider business mailing address

2100 N WALDRON ST STE 2
HUTCHINSON KS
67502-1176
US

V. Phone/Fax

Practice location:
  • Phone: 620-833-0960
  • Fax: 833-615-2260
Mailing address:
  • Phone: 620-833-0960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License Number55152
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number55152
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: