Provider Demographics
NPI:1629023932
Name:FLEMING, VALENCIA CAROL (FNP)
Entity Type:Individual
Prefix:MS
First Name:VALENCIA
Middle Name:CAROL
Last Name:FLEMING
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 COBBLESTONE CREEK CT
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-2657
Mailing Address - Country:US
Mailing Address - Phone:901-828-2077
Mailing Address - Fax:770-970-0969
Practice Address - Street 1:5757 PLAZA DRVIE
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-5000
Practice Address - Country:US
Practice Address - Phone:770-324-3692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN 91955363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNS85245Medicare UPIN