Provider Demographics
NPI:1083094247
Name:FLECKENSTEIN, ADRIANNE MARIE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ADRIANNE
Middle Name:MARIE
Last Name:FLECKENSTEIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:ADRIANNE
Other - Middle Name:MARIE
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2123 AUBURN AVE STE 520
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2906
Mailing Address - Country:US
Mailing Address - Phone:513-585-1300
Mailing Address - Fax:513-585-1358
Practice Address - Street 1:2123 AUBURN AVE STE 520
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-585-1300
Practice Address - Fax:513-585-1358
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.314595363LF0000X
OHCNP.17552363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0137367Medicaid
KY7100422560Medicaid