Individual
MRS. FELECIA GAIL ABDELFATTAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN BC
Contact information
Practice address
1145 VOLUNTEER PKWY, BRISTOL, TN 37620-4652
(423) 989-4500
(423) 989-4582
Mailing address
PO BOX 9054, GRAY, TN 37615-9054
(423) 467-3600
(423) 467-3696
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024164353
VA
363LF0000X
Family Nurse Practitioner
Primary
7668
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
188508
COMPSYCH
—
05
—
3349063
—
TN
01
—
334969
VALUE OPTIONS
—
01
—
351654200
DOL WORKERS COMP
—
05
—
3729687
—
TN
01
—
620582605
INITIAL GROUP
—
01
—
620582605BE
UBH JOHN DEERE
—
Enumeration date
08/14/2006
Last updated
11/05/2024
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