Provider Demographics
NPI:1225310634
Name:FELTON, HEIDI NICHOLE (PA)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:NICHOLE
Last Name:FELTON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3841 PIPER ST
Mailing Address - Street 2:SUITE T300
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4624
Mailing Address - Country:US
Mailing Address - Phone:907-563-3103
Mailing Address - Fax:907-561-1862
Practice Address - Street 1:3841 PIPER ST
Practice Address - Street 2:SUITE T300
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4624
Practice Address - Country:US
Practice Address - Phone:907-563-3103
Practice Address - Fax:907-561-1862
Is Sole Proprietor?:No
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant