Provider Demographics
NPI:1124800198
Name:FLECKENSTINE, BRIAN (MSN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:FLECKENSTINE
Suffix:
Gender:M
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10025 OAKLAND DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72118-1942
Mailing Address - Country:US
Mailing Address - Phone:501-800-4061
Mailing Address - Fax:501-800-1007
Practice Address - Street 1:924 MAIN ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-3818
Practice Address - Country:US
Practice Address - Phone:501-319-7074
Practice Address - Fax:501-246-3343
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR226157363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health