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General NPI Number Information
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NPI Number | 1467332544
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Entity Type | Individual
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Provider Name | GABRIELLE FECKERS
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Gender | Female
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 506 7TH ST W
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City | SAINT PAUL
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State | MN
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Zip | 55102-3049
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Country | US
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Telephone | 651-333-4420
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Fax | 651-204-0966
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Provider Business Mailing Address
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Address Line | 506 7TH ST W
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City | SAINT PAUL
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State | MN
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Zip | 55102-3049
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Country | US
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Telephone | 651-333-4420
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Fax | 651-204-0966
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 2609449
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License Number State | MN
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