Provider Demographics
NPI:1700350972
Name:GFELLER, TARINA A (APRN, CPNP)
Entity Type:Individual
Prefix:MS
First Name:TARINA
Middle Name:A
Last Name:GFELLER
Suffix:
Gender:F
Credentials:APRN, CPNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 725
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-0725
Mailing Address - Country:US
Mailing Address - Phone:316-283-3627
Mailing Address - Fax:316-283-3635
Practice Address - Street 1:700 MEDICAL CENTER DR
Practice Address - Street 2:STE 150
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-9015
Practice Address - Country:US
Practice Address - Phone:316-283-7100
Practice Address - Fax:316-283-7118
Is Sole Proprietor?:No
Enumeration Date:2019-01-21
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-78547-052363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
6736507OtherAETNA COMMERCIAL
KS1700350972OtherBLUE CROSS BLUE SHIELD
KS201231940AMedicaid
KSPDZ000000237358OtherAETNA BETTER HEALTH
0000701972OtherUNITED HEALTHCARE
25274OtherWPPA