Provider Demographics
NPI:1154798213
Name:FLEMING, JENNIFER ROZZELLE (CRNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ROZZELLE
Last Name:FLEMING
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 DOCTORS DR
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-2911
Mailing Address - Country:US
Mailing Address - Phone:334-793-8804
Mailing Address - Fax:334-699-4473
Practice Address - Street 1:102 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-2911
Practice Address - Country:US
Practice Address - Phone:334-793-8804
Practice Address - Fax:334-699-4473
Is Sole Proprietor?:No
Enumeration Date:2015-08-25
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-100198363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily