MEDICARE: BIANCA WATERS 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
1	2084P0800X	Psychiatry Physician	85458	GA
2	2084P0804X	Child & Adolescent Psychiatry Physician	85458	GA

General Provider Information

NPI Number	:	1255867131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BIANCA WATERS FLEMING

Provider Business Mailing Address
First Line	:	300 COLONIAL CENTER PKWY
Second Line	:
City	:	ROSWELL
State	:	GA
Zip	:	30076-4899
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 COLONIAL CENTER PKWY
Second Line	:
City	:	ROSWELL
State	:	GA
Zip	:	30076-4899
Country	:	US
Telephone Number	:	833-351-8255
Fax Number	:

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

Provider Enumeration Date	:	05/11/2017
Last Update Date	:	02/04/2026

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1831574425 — TASHUNDA J JONES
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Directions to “ BIANCA WATERS FLEMING ” Practice Location

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