Individual
NICHOLE EILEEN FELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
14601 DETROIT AVE, LAKEWOOD, OH 44107-4205
(162) 375-5002
Mailing address
17600 DETROIT AVE APT 603, LAKEWOOD, OH 44107-3440
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.005664RX
OH
Other
Enumeration date
09/13/2018
Last updated
10/25/2024
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