Provider Demographics
NPI:1285345181
Name:FLEMING, RICHARD BRADLEY (FNP-BC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:BRADLEY
Last Name:FLEMING
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3571 E AZALEA DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85298-2212
Mailing Address - Country:US
Mailing Address - Phone:480-527-1118
Mailing Address - Fax:
Practice Address - Street 1:7436 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85207-8338
Practice Address - Country:US
Practice Address - Phone:480-325-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ240866363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily