Provider Demographics
NPI:1073102596
Name:FELAND, KATHY JEANETTE
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:JEANETTE
Last Name:FELAND
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 1:11067 SWEARINGEN RD
Mailing Address - Street 2:
Mailing Address - City:SEALY
Mailing Address - State:TX
Mailing Address - Zip Code:77474-9523
Mailing Address - Country:US
Mailing Address - Phone:979-251-4793
Mailing Address - Fax:979-836-9144
Practice Address - Street 1:2508 S DAY ST
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-5521
Practice Address - Country:US
Practice Address - Phone:979-277-0906
Practice Address - Fax:979-836-9144
Is Sole Proprietor?:No
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician