Individual
MATTHEW BLAKE FLEMING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
2416 HIGHWAY 43 S STE B, PICAYUNE, MS 39466-7462
(769) 242-2525
Mailing address
2416 HIGHWAY 43 S, PICAYUNE, MS 39466-7415
(769) 242-2525
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
894301
MS
363LF0000X
Family Nurse Practitioner
Primary
906539
MS
Other
Enumeration date
08/31/2023
Last updated
02/22/2024
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