Provider Demographics
NPI:1356475396
Name:FLEMING, PAMELA HAMBLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:HAMBLEN
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 1:6859 S EASTERN AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-0002
Mailing Address - Country:US
Mailing Address - Phone:702-641-3008
Mailing Address - Fax:702-471-7580
Practice Address - Street 1:6859 S EASTERN AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-0002
Practice Address - Country:US
Practice Address - Phone:702-641-3008
Practice Address - Fax:702-471-7580
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB361111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVB361OtherNEVADA STATE LICENSE
NVB361OtherNEVADA STATE LICENSE
NVVDC361Medicare ID - Type Unspecified