Provider Demographics
NPI:1316284839
Name:FLEMING, KARI JO E (PA-C)
Entity type:Individual
Prefix:
First Name:KARI JO
Middle Name:E
Last Name:FLEMING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KARI JO
Other - Middle Name:E
Other - Last Name:CARLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:401 9TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:SD
Mailing Address - Zip Code:57201-1548
Mailing Address - Country:US
Mailing Address - Phone:605-882-7000
Mailing Address - Fax:605-882-5452
Practice Address - Street 1:401 9TH AVE NW
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-1548
Practice Address - Country:US
Practice Address - Phone:605-882-7000
Practice Address - Fax:605-882-5452
Is Sole Proprietor?:No
Enumeration Date:2013-01-04
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant