MEDICARE: WINDI JEAN FLETCHER RDH

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	124Q00000X	Dental Hygienist	10701	TN

General Provider Information

NPI Number	:	1528942042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WINDI JEAN FLETCHER RDH

Provider Business Mailing Address
First Line	:	196 HUGHEY RD
Second Line	:
City	:	FAYETTEVILLE
State	:	TN
Zip	:	37334-6401
Country	:	US
Telephone Number	:	775-240-0444
Fax Number	:

Provider Business Practice Location Address
First Line	:	196 HUGHEY RD
Second Line	:
City	:	FAYETTEVILLE
State	:	TN
Zip	:	37334-6401
Country	:	US
Telephone Number	:	775-240-0444
Fax Number	:

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

Provider Enumeration Date	:	08/05/2025
Last Update Date	:	08/05/2025

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