Provider Demographics
NPI:1508814013
Name:FLEEMAN, BRIAN (CRNA)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:FLEEMAN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 N WALDRON ST STE 2
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1176
Mailing Address - Country:US
Mailing Address - Phone:620-833-0960
Mailing Address - Fax:
Practice Address - Street 1:2100 N WALDRON ST STE 2
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-1176
Practice Address - Country:US
Practice Address - Phone:620-833-0960
Practice Address - Fax:833-615-2260
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS55152367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS145239OtherBCBS
145239Medicare ID - Type Unspecified