Provider Demographics
NPI:1073743720
Name:FLEMING, JESSICA A (DC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:A
Last Name:FLEMING
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4130 PIONEER WOODS DR STE 3
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-7552
Mailing Address - Country:US
Mailing Address - Phone:402-261-6841
Mailing Address - Fax:
Practice Address - Street 1:4130 PIONEER WOODS DR
Practice Address - Street 2:STE 3
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-7552
Practice Address - Country:US
Practice Address - Phone:402-261-6841
Practice Address - Fax:402-261-6843
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-15
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011251111N00000X
NE1637111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1637OtherLICENSE
IL038011251OtherLICENSE NUMBER