Individual
THEA FLEMING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2525 CHICAGO AVE, MINNEAPOLIS, MN 55404-4518
(612) 813-6000
Mailing address
1609 E 53RD ST, MINNEAPOLIS, MN 55417-1816
(612) 616-2064
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
R 188429-6
MN
363LP0200X
Pediatric Nurse Practitioner
Primary
CNP 4685
MN
Other
Enumeration date
05/06/2016
Last updated
07/22/2016
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