Provider Demographics
NPI:1669790168
Name:FELLION, JONATHAN FRANCIS-ANTHONY (FPNP)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:FRANCIS-ANTHONY
Last Name:FELLION
Suffix:
Gender:M
Credentials:FPNP
Other - Prefix:
Other - First Name:JONATHAN
Other - Middle Name:FRANCIS
Other - Last Name:FELLION
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP/PCNS
Mailing Address - Street 1:2616 WILMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-1530
Mailing Address - Country:US
Mailing Address - Phone:724-652-2323
Mailing Address - Fax:
Practice Address - Street 1:2616 WILMINGTON RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105
Practice Address - Country:US
Practice Address - Phone:724-652-2323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-07
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA503016L163WP0807X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX742761795OtherDEPARTMENT OF DEFENSE