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NPI Code Detail

MEDICARE: BRIDGETT FLEMING

MEDICARE:   BRIDGETT  FLEMING
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1174882401
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIDGETT FLEMING
Provider Business Mailing Address
First Line : 5625 GRANVILLE LAKE ST
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-3695
Country : US
Telephone Number : 702-788-7756
Fax Number :
Provider Business Practice Location Address
First Line : 5625 GRANVILLE LAKE ST
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-3695
Country : US
Telephone Number : 702-788-7756
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2012
Last Update Date : 05/07/2012

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Directions to “ BRIDGETT FLEMING ” Practice Location

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