MEDICARE: MS. THERESA K FLEMMING NP

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	174400000X	Specialist
2	363LF0000X	Family Nurse Practitioner	14899	CA

General Provider Information

NPI Number	:	1346238078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. THERESA K FLEMMING NP

Provider Business Mailing Address
First Line	:	161600 EUREKA RD
Second Line	:
City	:	ROSEVILLE
State	:	CA
Zip	:	95661-3027
Country	:	US
Telephone Number	:	916-225-7098
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 EUREKA RD
Second Line	:
City	:	ROSEVILLE
State	:	CA
Zip	:	95661-3027
Country	:	US
Telephone Number	:	916-784-4048
Fax Number	:	916-784-5604

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

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	02/02/2022

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