Healthcare Provider Details

I. General information

NPI: 1306780978
Provider Name (Legal Business Name): KAYLA FELLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WELTON DR
CUMBERLAND MD
21502-1336
US

IV. Provider business mailing address

100 WELTON DR
CUMBERLAND MD
21502-1336
US

V. Phone/Fax

Practice location:
  • Phone: 301-777-7900
  • Fax: 301-724-5590
Mailing address:
  • Phone: 301-777-7900
  • Fax: 301-724-5590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR249882
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: