Provider Demographics
NPI:1003090614
Name:GFELLER, ELRAH F (PA-C)
Entity Type:Individual
Prefix:
First Name:ELRAH
Middle Name:F
Last Name:GFELLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ELRAH
Other - Middle Name:
Other - Last Name:O'GARRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6355 S BUFFALO DR FL 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2133
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:702-671-6883
Practice Address - Street 1:9260 W SUNSET RD STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-4903
Practice Address - Country:US
Practice Address - Phone:702-968-3240
Practice Address - Fax:702-862-8227
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA910363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1003090614Medicaid
NV1003090614Medicaid