Provider Demographics
NPI:1740967553
Name:FLEMING, AMBER (APRN)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:FLEMING
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2558 KNOX ROAD 1000 E
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:IL
Mailing Address - Zip Code:61467-9534
Mailing Address - Country:US
Mailing Address - Phone:309-371-8631
Mailing Address - Fax:
Practice Address - Street 1:3375 N SEMINARY ST
Practice Address - Street 2:
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-1251
Practice Address - Country:US
Practice Address - Phone:309-343-5114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.027795363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily