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OPAL PEGGYSUE FELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1301 W 12TH AVE, STE 401, EMPORIA, KS 66801-2587
(620) 343-2900
(620) 343-9484
Mailing address
1301 W 12TH AVE, STE 401, EMPORIA, KS 66801-2587
(620) 343-2900
(620) 343-9484

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
75138
KS
363LA2200X
Adult Health Nurse Practitioner
53-75138-122
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
068002355
MEDICARE PTAN
KS
Enumeration date
07/27/2010
Last updated
03/25/2022
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