Provider Demographics
NPI:1730451378
Name:FLEMING, TEIA R (CRNA)
Entity type:Individual
Prefix:
First Name:TEIA
Middle Name:R
Last Name:FLEMING
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7700 WEST SUNRISE BLVD
Mailing Address - Street 2:PL-14-MAIL
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-4113
Mailing Address - Country:US
Mailing Address - Phone:954-838-2371
Mailing Address - Fax:954-851-1746
Practice Address - Street 1:403 BURKARTH RD
Practice Address - Street 2:
Practice Address - City:WARREBSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093
Practice Address - Country:US
Practice Address - Phone:660-747-2500
Practice Address - Fax:816-335-4003
Is Sole Proprietor?:No
Enumeration Date:2012-01-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2012002916367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered