Provider Demographics
NPI:1487168274
Name:FELDER, PATRICIA NICOLE
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:NICOLE
Last Name:FELDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3350 SWEETWATER RD APT 1419
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-6582
Mailing Address - Country:US
Mailing Address - Phone:770-375-1730
Mailing Address - Fax:
Practice Address - Street 1:270 CARPENTER DR, NE
Practice Address - Street 2:SUITE # 400
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328
Practice Address - Country:US
Practice Address - Phone:678-460-0345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-01
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program