Provider Demographics
NPI:1902120793
Name:FLEMMING, DEBORAH KAYE (LPN)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:KAYE
Last Name:FLEMMING
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3483 OAKCREST RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-4052
Mailing Address - Country:US
Mailing Address - Phone:614-338-0318
Mailing Address - Fax:
Practice Address - Street 1:3483 OAKCREST RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-4052
Practice Address - Country:US
Practice Address - Phone:614-338-0318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-051241164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPN-051241OtherLPN LICENSE