Provider Demographics
NPI:1114707965
Name:FLEMING, LAQUINN NICOLE
Entity Type:Individual
Prefix:MS
First Name:LAQUINN
Middle Name:NICOLE
Last Name:FLEMING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 AFFIRMED DR
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29316-8003
Mailing Address - Country:US
Mailing Address - Phone:864-415-7910
Mailing Address - Fax:
Practice Address - Street 1:870 AFFIRMED DR
Practice Address - Street 2:
Practice Address - City:BOILING SPRINGS
Practice Address - State:SC
Practice Address - Zip Code:29316-8003
Practice Address - Country:US
Practice Address - Phone:864-415-7910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC97501163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse