Basic Information
Provider Information
NPI: 1619915477
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FLEMING
FirstName: HILARI
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: M.D., PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5590 KIETZKE LN
Address2:  
City: RENO
State: NV
PostalCode: 895113019
CountryCode: US
TelephoneNumber: 7753232080
FaxNumber: 7753238216
Practice Location
Address1: 5590 KIETZKE LN
Address2:  
City: RENO
State: NV
PostalCode: 895113019
CountryCode: US
TelephoneNumber: 7753232080
FaxNumber: 7753238216
Other Information
ProviderEnumerationDate: 06/03/2006
LastUpdateDate: 03/25/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207T00000X6196NVY Allopathic & Osteopathic PhysiciansNeurological Surgery 

ID Information
IDTypeStateIssuerDescription
CC171801NVBC/BSOTHER
00201646105NV MEDICAID
880167036A01501NVTRICAREOTHER
XPY11988005CA MEDICAID


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