Provider Demographics
NPI:1740340165
Name:FLEMING, CAROLE SIXT (NP)
Entity type:Individual
Prefix:MS
First Name:CAROLE
Middle Name:SIXT
Last Name:FLEMING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CAROLE
Other - Middle Name:JEANNE
Other - Last Name:SIXT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:122 LA ALONDRA CT
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-4519
Mailing Address - Country:US
Mailing Address - Phone:650-250-2883
Mailing Address - Fax:
Practice Address - Street 1:122 LA ALONDRA CT
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-4519
Practice Address - Country:US
Practice Address - Phone:650-250-2883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95005050363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily