Provider Demographics
NPI:1770394645
Name:FLEMING, LEEANN (MSN, RN, PMHNP)
Entity type:Individual
Prefix:
First Name:LEEANN
Middle Name:
Last Name:FLEMING
Suffix:
Gender:F
Credentials:MSN, RN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-6536
Mailing Address - Country:US
Mailing Address - Phone:903-501-1747
Mailing Address - Fax:903-234-9769
Practice Address - Street 1:1736 FM 2011
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75603-4317
Practice Address - Country:US
Practice Address - Phone:903-736-1940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-18
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20240963482084B0040X, 103TA0400X
TX1002503363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & Neuropsychiatry
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)