Provider Demographics
NPI:1770602229
Name:FELKER, ISABELL (SLP)
Entity type:Individual
Prefix:
First Name:ISABELL
Middle Name:
Last Name:FELKER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 105
Mailing Address - Street 2:
Mailing Address - City:MOUNT SHERMAN
Mailing Address - State:KY
Mailing Address - Zip Code:42764-0105
Mailing Address - Country:US
Mailing Address - Phone:270-324-2850
Mailing Address - Fax:
Practice Address - Street 1:190 HOWARD MARCUM RD
Practice Address - Street 2:
Practice Address - City:MOUNT SHERMAN
Practice Address - State:KY
Practice Address - Zip Code:42764
Practice Address - Country:US
Practice Address - Phone:270-324-2850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2470235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY186517Medicare ID - Type UnspecifiedMEDICARE NUMBER
KY186517Medicare ID - Type UnspecifiedMEDICARE NUMBER