MEDICARE: MS. CYNTHIA MARIE FELLER CRNA

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	367500000X	Certified Registered Nurse Anesthetist	308066-1	NY

General Provider Information

NPI Number	:	1902806037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CYNTHIA MARIE FELLER CRNA

Provider Business Mailing Address
First Line	:	3172 SPEICHER CIR
Second Line	:
City	:	LEMOORE
State	:	CA
Zip	:	93245-2233
Country	:	US
Telephone Number	:	559-998-8986
Fax Number	:

Provider Business Practice Location Address
First Line	:	NAVAL HOSPITAL LEMOORE
Second Line	:	937 FRANKLIN AVE
City	:	LEMOORE
State	:	CA
Zip	:	93246-0001
Country	:	US
Telephone Number	:	559-998-4201
Fax Number	:	559-998-4682

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	10/27/2009

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