Individual
NICOLE ANN FELLOWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
11886
MN
363A00000X
Physician Assistant
Primary
12762100-1206
UT
363A00000X
Physician Assistant
—
MN
Other
Enumeration date
06/08/2015
Last updated
06/09/2022
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