Fellers, Kent M

Fellers, Kent M is an individual health care provider with primary practice located at 14000 Fivay Rd , Hudson FL 34667-7103. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Fellers, Kent M can be contacted via phone (260) 484-8551.

Contact Information

Primary practice address
14000 Fivay Rd Hudson FL 34667-7103
Phone: (260) 484-8551
Fax: (260) 482-5060
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN229962 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 051088 Florida
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 28108380A Indiana

Profile Details

NPI number 1104831791
LBN Legal business name Fellers, Kent M
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 30th, 2006
Last updated Apr 6th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104831791 NPPES
Indiana Other 000000675839 ANTHEM
Indiana MEDICAID 200998230 ANTHEM

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