MEDICARE: MS. MELINDA ANN FLEMING RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse		OR

General Provider Information

NPI Number	:	1033393004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELINDA ANN FLEMING RN

Provider Business Mailing Address
First Line	:	9940 N SYRACUSE STREET
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97203-1436
Country	:	US
Telephone Number	:	503-502-0189
Fax Number	:

Provider Business Practice Location Address
First Line	:	9940 N SYRACUSE STREET
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97203-1436
Country	:	US
Telephone Number	:	503-502-0189
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2007
Last Update Date	:	12/26/2007

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