Provider Demographics
NPI:1063014330
Name:FLEMING, CINDY (FNP)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:
Last Name:FLEMING
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14074 PASCO MONTRA RD
Mailing Address - Street 2:
Mailing Address - City:ANNA
Mailing Address - State:OH
Mailing Address - Zip Code:45302-9708
Mailing Address - Country:US
Mailing Address - Phone:937-489-0828
Mailing Address - Fax:
Practice Address - Street 1:1149 EXPERIMENT FARM RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-1071
Practice Address - Country:US
Practice Address - Phone:937-540-9920
Practice Address - Fax:937-202-0213
Is Sole Proprietor?:No
Enumeration Date:2020-11-12
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0028000363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily