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NPI Code Detail

MEDICARE: KELLEY ANN FIEDLER

MEDICARE: KELLEY ANN FIEDLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist27165MD

General Provider Information

NPI Number : 1053892380
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLEY ANN FIEDLER
Provider Business Mailing Address
First Line : 350 NEW FIDELITY CT
Second Line :
City : GARNER
State : NC
Zip : 27529-2665
Country : US
Telephone Number : 919-258-2714
Fax Number : 410-648-4878
Provider Business Practice Location Address
First Line : 5100 BUCKEYSTOWN PIKE STE 158
Second Line :
City : FREDERICK
State : MD
Zip : 21704-8337
Country : US
Telephone Number : 301-662-6790
Fax Number : 301-662-6805
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2018
Last Update Date : 05/21/2020

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Directions to “ KELLEY ANN FIEDLER ” Practice Location

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