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NPI Code Detail

MEDICARE: KATHLEEN MARIE FEELEY CRNA

MEDICARE: KATHLEEN MARIE FEELEY CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistR0081540OK

General Provider Information

NPI Number : 1295735777
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN MARIE FEELEY CRNA
Provider Business Mailing Address
First Line : PO BOX 785
Second Line :
City : LAWTON
State : OK
Zip : 73502-0785
Country : US
Telephone Number : 580-357-9984
Fax Number : 580-357-3277
Provider Business Practice Location Address
First Line : 3401 W GORE BLVD
Second Line :
City : LAWTON
State : OK
Zip : 73505-6332
Country : US
Telephone Number : 580-355-8620
Fax Number : 580-357-3277
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2005
Last Update Date : 07/08/2007

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Directions to “ KATHLEEN MARIE FEELEY CRNA” Practice Location

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