Provider Demographics
NPI:1457975740
Name:BLEEMIE, AYEE TEAH (NP)
Entity type:Individual
Prefix:
First Name:AYEE
Middle Name:TEAH
Last Name:BLEEMIE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6907 ENNIS DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-5603
Mailing Address - Country:US
Mailing Address - Phone:773-715-7219
Mailing Address - Fax:317-659-8825
Practice Address - Street 1:ROUNDING PROVIDERS
Practice Address - Street 2:6326 CONSTITUTION DRIVE
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-4680
Practice Address - Country:US
Practice Address - Phone:260-515-3275
Practice Address - Fax:888-803-6843
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71010114A363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily