Colleen Fussell, ATC
Individual provider Active NPI Athletic Trainer · Nelsonville, OH
NPI 1043799141 · NPPES record last updated Aug 9, 2018
Key facts
- NPI
- 1043799141
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- AT5693 (OH)
- Practice address
- 2 Buckeye Dr
Nelsonville, OH 45764-9591 - Phone
- (407) 595-7793
- NPI assigned
- Aug 9, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| GUG3YD | FL | MD | Sports Medicine (Emergency Medicine) Physician |
| AT5693 | OH | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Emergency Medicine) Physician | 207PS0010X | GUG3YD | FL | |
| Athletic Trainer | 2255A2300X | AT5693 | OH | Yes |
Addresses
Primary practice location
2 Buckeye Dr
Nelsonville, OH 45764-9591
Mailing address
363 Richland Ave Apt 280
Athens, OH 45701-3281
Phone (407) 595-7793
Other providers in Nelsonville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.