Provider Demographics
NPI:1851370498
Name:FLEIG, CARLINE LECLERC (RNP)
Entity Type:Individual
Prefix:
First Name:CARLINE
Middle Name:LECLERC
Last Name:FLEIG
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:RI
Mailing Address - Zip Code:02871-2247
Mailing Address - Country:US
Mailing Address - Phone:401-683-0671
Mailing Address - Fax:401-254-3305
Practice Address - Street 1:1 OLD FERRY RD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:RI
Practice Address - Zip Code:02809-2938
Practice Address - Country:US
Practice Address - Phone:401-254-3156
Practice Address - Fax:401-254-3305
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP34592363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI2180454OtherUNITED HEALTH CARE
RI26376OtherBLUE CROSS