Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 35085544 | OH |
NPI | 1063404309 |
---|---|
Provider Name | Dr. Trista Kay Schrickel Feller |
First Address | Marysville, OH 43040-8648 |
Second Address | Marysville, OH 43040-1646 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2573362 | (05) | OH |
I31320 | (02) | OH |