Provider Demographics
NPI:1215243076
Name:FLEMING, PATRICIA ANN (RD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:FLEMING
Suffix:
Gender:
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 VAN EDEN RD
Mailing Address - Street 2:
Mailing Address - City:IDAHO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80452-9561
Mailing Address - Country:US
Mailing Address - Phone:303-567-2566
Mailing Address - Fax:303-567-2566
Practice Address - Street 1:3001 VAN EDEN RD
Practice Address - Street 2:
Practice Address - City:IDAHO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80452-9561
Practice Address - Country:US
Practice Address - Phone:303-567-2566
Practice Address - Fax:303-567-2566
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2025-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO356171133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO7091511-01Medicare PIN