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General NPI Number Information
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NPI Number | 1790032084
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Entity Type | Individual
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Provider Name | KRISTIN ELISABETH FLEMING D.O.
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Gender | Female
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Dates
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Enumeration Date | 08/06/2012
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Last Update Date | 08/01/2023
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Provider Practice Location Address
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Address Line | 18TH MEDICAL GROUP, UNIT 5142
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City | APO
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State | AP
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Zip | 96368-5142
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Country | US
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Telephone | 315-630-3618
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 80 BOX 15682
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City | APO
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State | AP
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Zip | 96367-0059
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Country | US
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Telephone | 267-441-7820
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 02003993A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | 02003993A
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License Number State | IN
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