Provider Demographics
NPI:1790976173
Name:FLEMING, AMY LOUISE (PA)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LOUISE
Last Name:FLEMING
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:4500 MEMORIAL DRIVE
Mailing Address - Street 2:MEMORIAL HOSPITAL MEDICAL AFFAIRS
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62226
Mailing Address - Country:US
Mailing Address - Phone:618-257-4644
Mailing Address - Fax:
Practice Address - Street 1:4600 MEMORIAL DR
Practice Address - Street 2:SUITE 120
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62226-5368
Practice Address - Country:US
Practice Address - Phone:618-257-4644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2016-03-04
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant