Provider Demographics
NPI:1326231689
Name:FLEMING, SHEILA M (NP)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:M
Last Name:FLEMING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46526-3800
Mailing Address - Country:US
Mailing Address - Phone:574-364-4600
Mailing Address - Fax:574-364-4610
Practice Address - Street 1:1135 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:IN
Practice Address - Zip Code:46526-3800
Practice Address - Country:US
Practice Address - Phone:574-364-4600
Practice Address - Fax:574-364-4610
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002560A363LA2200X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300001623Medicaid
IN000000544149OtherANTHEM
IN200897360Medicaid
IN71002560AOtherLICENSE
IN71002560AOtherLICENSE
MIN43780011Medicare PIN