Healthcare Provider Details

I. General information

NPI: 1700856481
Provider Name (Legal Business Name): KAREN ANNE FELL ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 10/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 GAFFNEY RD #7440 BASSETT ARMY COMMUNITY HOSPITAL
FORT WAINWRIGHT AK
99703-7440
US

IV. Provider business mailing address

1060 GAFFNEY RD #7440 COMMANDER, USA-MEDDAC-AK, ATTN: MCUC-MMD-QM
FORT WAINWRIGHT AK
99703-5001
US

V. Phone/Fax

Practice location:
  • Phone: 907-353-5418
  • Fax: 907-353-4845
Mailing address:
  • Phone: 907-361-6703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNURU1419
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberNURR25675
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: