Healthcare Provider Details

I. General information

NPI: 1720591654
Provider Name (Legal Business Name): REBECCA FLEMING APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2017
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEMORIAL MEDICAL CENTER 1615 MAPLE LANE
ASHLAND WI
54806-3610
US

IV. Provider business mailing address

MEMORIAL MEDICAL CENTER 1615 MAPLE LANE
ASHLAND WI
54806-3610
US

V. Phone/Fax

Practice location:
  • Phone: 715-685-5513
  • Fax: 715-682-4022
Mailing address:
  • Phone: 715-685-5513
  • Fax: 715-682-4022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number8137-33
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number8137-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: