MEDICARE: BRIAN FLEEMAN CRNA

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	163WP0000X	Pain Management Registered Nurse	55152	KS
2	367500000X	Certified Registered Nurse Anesthetist	55152	KS

General Provider Information

NPI Number	:	1508814013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN FLEEMAN CRNA

Provider Business Mailing Address
First Line	:	2100 N WALDRON ST STE 2
Second Line	:
City	:	HUTCHINSON
State	:	KS
Zip	:	67502-1176
Country	:	US
Telephone Number	:	620-833-0960
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 N WALDRON ST STE 2
Second Line	:
City	:	HUTCHINSON
State	:	KS
Zip	:	67502-1176
Country	:	US
Telephone Number	:	620-833-0960
Fax Number	:	833-615-2260

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

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	06/28/2024

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