Healthcare Provider Details

I. General information

NPI: 1366390965
Provider Name (Legal Business Name): MATTI ANGELINA FLEMING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 W C ST APT 309
LINCOLN NE
68522-1279
US

IV. Provider business mailing address

1121 W C ST APT 309
LINCOLN NE
68522-1279
US

V. Phone/Fax

Practice location:
  • Phone: 402-269-6667
  • Fax:
Mailing address:
  • Phone: 402-269-6667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: