Individual
MS. KELLE FECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
425 PINE RIDGE BLVD, STE 211, WAUSAU, WI 54401
(715) 845-5505
(715) 848-2884
Mailing address
425 PINE RIDGE BLVD, STE 211, WAUSAU, WI 54401
(715) 845-5505
(715) 848-2884
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
145896030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003921305
HUMAN GOLD MEDICARE
WI
01
—
391330887
ASSOCIATES FOR HEALTHCARE
WI
01
—
44326600
MANAGED HEALTH CARE
WI
05
—
44326600
—
WI
01
—
88792
SECURITY HEALTH PLAN
WI
01
—
P00088510
MEDICARE RAILROAD
WI
01
—
SWOPE
WPS
WI
Enumeration date
06/12/2006
Last updated
10/22/2010
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