=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194790758
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAREN M FLEMING NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/17/2006
-----------------------------------------------------
Last Update Date | 04/12/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 385 SOUTHBRIDGE ST
-----------------------------------------------------
City | AUBURN
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01501-2498
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-721-1170
-----------------------------------------------------
Fax | 508-832-0859
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5 NEPONSET ST FL ST2
-----------------------------------------------------
City | WORCESTER
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01606-2714
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-368-5532
-----------------------------------------------------
Fax | 508-832-0859
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | RN165966
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------