Provider Demographics
NPI:1023255494
Name:FLEMING, MINER C (RN)
Entity type:Individual
Prefix:MR
First Name:MINER
Middle Name:C
Last Name:FLEMING
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 S ALMA SCHOOL RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-3001
Mailing Address - Country:US
Mailing Address - Phone:480-831-7566
Mailing Address - Fax:480-962-7671
Practice Address - Street 1:1811 S ALMA SCHOOL RD
Practice Address - Street 2:SUITE 160
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-3001
Practice Address - Country:US
Practice Address - Phone:480-831-7566
Practice Address - Fax:480-962-7671
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN069644163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator