Provider Demographics
NPI:1982730057
Name:FLEMING, DEBRA L (ANP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:L
Last Name:FLEMING
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6904 JASPER DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-8748
Mailing Address - Country:US
Mailing Address - Phone:214-649-0777
Mailing Address - Fax:
Practice Address - Street 1:14655 PRESTON RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-7805
Practice Address - Country:US
Practice Address - Phone:214-649-0777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX641554363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NP0162Medicare PIN
S40345Medicare UPIN
NP0260Medicare PIN