Healthcare Provider Details

I. General information

NPI: 1255267985
Provider Name (Legal Business Name): ANNA FEELEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 MAIN ST S APT B
MINOT ND
58701-7545
US

IV. Provider business mailing address

3920 MAIN ST S APT B
MINOT ND
58701-7545
US

V. Phone/Fax

Practice location:
  • Phone: 701-509-5861
  • Fax:
Mailing address:
  • Phone: 701-509-5861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: