Provider Demographics
NPI:1598045890
Name:FLEMISTER, JANICIA SHARRON (STNA)
Entity Type:Individual
Prefix:MS
First Name:JANICIA
Middle Name:SHARRON
Last Name:FLEMISTER
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20619 GARDENVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MAPLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44137-2417
Mailing Address - Country:US
Mailing Address - Phone:216-310-1594
Mailing Address - Fax:
Practice Address - Street 1:20619 GARDENVIEW DR
Practice Address - Street 2:
Practice Address - City:MAPLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44137-2417
Practice Address - Country:US
Practice Address - Phone:216-310-1594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401159571010376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide