Healthcare Provider Details

I. General information

NPI: 1437689247
Provider Name (Legal Business Name): GAIL T FLEMING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 OLIVE ST STE 500
SAINT LOUIS MO
63103-2377
US

IV. Provider business mailing address

1430 OLIVE ST STE 500
SAINT LOUIS MO
63103-2377
US

V. Phone/Fax

Practice location:
  • Phone: 314-285-2465
  • Fax: 314-206-3708
Mailing address:
  • Phone: 314-285-2465
  • Fax: 314-206-3708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number2003025374
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: