Provider Demographics
NPI:1760057467
Name:FELLENZ, MAY BELLE JAY (FNP - BC)
Entity Type:Individual
Prefix:
First Name:MAY BELLE
Middle Name:JAY
Last Name:FELLENZ
Suffix:
Gender:F
Credentials:FNP - BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59C BARCLAY PLACE CT APT C
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-2494
Mailing Address - Country:US
Mailing Address - Phone:501-881-8106
Mailing Address - Fax:
Practice Address - Street 1:59C BARCLAY PLACE CT APT C
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-2494
Practice Address - Country:US
Practice Address - Phone:501-881-8106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001301530163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical