Healthcare Provider Details

I. General information

NPI: 1669790168
Provider Name (Legal Business Name): JONATHAN FRANCIS-ANTHONY FELLION FPNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JONATHAN FRANCIS FELLION CRNP/PCNS

II. Dates (important events)

Enumeration Date: 05/07/2010
Last Update Date: 05/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2616 WILMINGTON RD
NEW CASTLE PA
16105
US

IV. Provider business mailing address

2616 WILMINGTON RD
NEW CASTLE PA
16105-1530
US

V. Phone/Fax

Practice location:
  • Phone: 724-652-2323
  • Fax:
Mailing address:
  • Phone: 724-652-2323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number503016L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number503016L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: