MEDICARE: ELIZABETH NICOLE FLEMING MS

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	235Z00000X	Speech-Language Pathologist	2023033451	MO

General Provider Information

NPI Number	:	1194572107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH NICOLE FLEMING MS

Provider Business Mailing Address
First Line	:	1874 CATLIN DR
Second Line	:
City	:	BARNHART
State	:	MO
Zip	:	63012-1204
Country	:	US
Telephone Number	:	314-686-5274
Fax Number	:

Provider Business Practice Location Address
First Line	:	4814 S LINDBERGH BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63126-3233
Country	:	US
Telephone Number	:	314-729-2434
Fax Number	:

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

Provider Enumeration Date	:	05/06/2024
Last Update Date	:	05/06/2024

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