Provider Demographics
NPI:1275122053
Name:FELTON, MAGDALENA (NP-C)
Entity Type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:
Last Name:FELTON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2524 PAPER MILL RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:MD
Mailing Address - Zip Code:21131-1326
Mailing Address - Country:US
Mailing Address - Phone:410-627-4165
Mailing Address - Fax:
Practice Address - Street 1:2524 PAPER MILL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:MD
Practice Address - Zip Code:21131-1326
Practice Address - Country:US
Practice Address - Phone:410-627-4165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program