Basic Information
| Provider Information | |||||||||
| NPI: | 1467878421 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FLEMING | ||||||||
| FirstName: | TANYA | ||||||||
| MiddleName: | RAWLINGS | ||||||||
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| Credential: | RN, BSN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2868 ACTON RD | ||||||||
| Address2: | |||||||||
| City: | VESTAVIA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352432502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059688360 | ||||||||
| FaxNumber: | 2059688361 | ||||||||
| Practice Location | |||||||||
| Address1: | 1410 GLORY WAY | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 356331640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567652230 | ||||||||
| FaxNumber: | 2567744573 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/13/2014 | ||||||||
| LastUpdateDate: | 03/13/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 1-117935 | AL | Y | Nursing Service Providers | Registered Nurse |
No ID Information.