Provider Demographics
NPI:1184864993
Name:FLEENOR, RACHEL J (ST)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:J
Last Name:FLEENOR
Suffix:
Gender:F
Credentials:ST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 LINCOLN PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-3492
Mailing Address - Country:US
Mailing Address - Phone:937-293-5567
Mailing Address - Fax:937-293-5568
Practice Address - Street 1:500 LINCOLN PARK BLVD
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-3492
Practice Address - Country:US
Practice Address - Phone:937-293-5567
Practice Address - Fax:937-293-5568
Is Sole Proprietor?:No
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist