Individual provider Active NPI

Connie Marie Fleischer, LPN

  • Licensed Practical Nurse
  • Allen Park, MI
National Provider Identifier
1255535605
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703097891 Issued in MI
Practice address
7148 Osage Ave
Allen Park, MI 48101-2473
Phone
(313) 383-0879
NPI assigned
Jun 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703097891 MI Primary

Addresses

Primary practice location

7148 Osage Ave
Allen Park, MI 48101-2473

Mailing address

7148 Osage Ave
Allen Park, MI 48101-2473
Phone (313) 383-0879

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4703097891MIMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255535605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7148 OSAGE AVE",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481012473",
            "telephone_number": "313-383-0879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7148 OSAGE AVE",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481012473",
            "telephone_number": "313-383-0879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEISCHER",
        "first_name": "CONNIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703097891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.