Provider Demographics
NPI:1598237208
Name:FLEMING, LASONDA ELDER (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:LASONDA
Middle Name:ELDER
Last Name:FLEMING
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1847 BREWER BLVD SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310-4907
Mailing Address - Country:US
Mailing Address - Phone:404-948-8374
Mailing Address - Fax:
Practice Address - Street 1:1847 BREWER BLVD SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30310-4907
Practice Address - Country:US
Practice Address - Phone:404-948-8374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA125337363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily