Provider Demographics
NPI:1871611186
Name:FLECKSTEINER, DAVID J (RN, C, MSN)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:FLECKSTEINER
Suffix:
Gender:M
Credentials:RN, C, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 BENTON AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-2303
Mailing Address - Country:US
Mailing Address - Phone:615-292-9770
Mailing Address - Fax:615-385-1842
Practice Address - Street 1:312 ROSA L PARKS AVE STE 3.380
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37243-1102
Practice Address - Country:US
Practice Address - Phone:615-741-1709
Practice Address - Fax:615-770-3863
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN 0000007866363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ016172Medicaid