MEDICARE: MS. DEBRA FELL FNP

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
1	363LF0000X	Family Nurse Practitioner	201594	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	500025665	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326025610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBRA FELL FNP

Provider Business Mailing Address
First Line	:	190 CAROLINA DR
Second Line	:
City	:	SNOW HILL
State	:	NC
Zip	:	28580-1651
Country	:	US
Telephone Number	:	252-747-2204
Fax Number	:	252-747-2210

Provider Business Practice Location Address
First Line	:	190 CAROLINA DR
Second Line	:
City	:	SNOW HILL
State	:	NC
Zip	:	28580-1651
Country	:	US
Telephone Number	:	252-747-2204
Fax Number	:	252-747-2210

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	02/05/2025

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