Basic Information
| Provider Information | |||||||||
| NPI: | 1730451378 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FLEMING | ||||||||
| FirstName: | TEIA | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7700 WEST SUNRISE BLVD | ||||||||
| Address2: | PL-14-MAIL | ||||||||
| City: | PLANTATION | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333224113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9548382371 | ||||||||
| FaxNumber: | 9548511746 | ||||||||
| Practice Location | |||||||||
| Address1: | 403 BURKARTH RD | ||||||||
| Address2: | |||||||||
| City: | WARREBSBURG | ||||||||
| State: | MO | ||||||||
| PostalCode: | 64093 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6607472500 | ||||||||
| FaxNumber: | 8163354003 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/28/2012 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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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 | 367500000X | 2012002916 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.