Provider Demographics
NPI:1861170136
Name:FLEMING, ALLISON J (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:J
Last Name:FLEMING
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5102 BROWN RD
Mailing Address - Street 2:
Mailing Address - City:KENOCKEE
Mailing Address - State:MI
Mailing Address - Zip Code:48006-3216
Mailing Address - Country:US
Mailing Address - Phone:810-300-0940
Mailing Address - Fax:
Practice Address - Street 1:1209 10TH ST
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-5262
Practice Address - Country:US
Practice Address - Phone:810-985-8170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIF06231998363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily