Individual
MRS. BRANDI MARIE FLEISCHMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
300 W HOSPITAL RD, FORT GORDON, GA 30905-4470
(706) 787-5811
Mailing address
300 W HOSPITAL RD, FORT GORDON, GA 30905-4470
(706) 787-5811
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10001620A
IN
363A00000X
Physician Assistant
1596
TN
363A00000X
Physician Assistant
Primary
PA1835
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10001620A
INDIANA STATE LICENSE
IN
01
—
1081766
NCCPA ID
TN
01
—
12511065
CAQH
KY
01
—
1596
TENNESSEE STATE LICENSE NUMBER
TN
01
—
PA1835
KENTUCKY STATE LICENSE
KY
Enumeration date
05/21/2008
Last updated
06/25/2025
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