| NPI | 1043527757 |
|---|---|
| Former Name | KELLY LANE FLEMING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005921) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105541) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA 9105541) | |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2020-04-29 |