Kathleen Marie Fennelly, R.N., N.P,

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

7319 Issued in CA

Practice address

896 E Foothill Blvd
San Luis Obispo, CA 93405-1761

Phone

(805) 542-0900

NPI assigned

Aug 18, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249516800000",
    "number": "1649262429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "896 E FOOTHILL BLVD",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051761",
            "telephone_number": "805-542-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "896 E FOOTHILL BLVD",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051761",
            "telephone_number": "805-542-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNELLY",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "credential": "R.N., N.P,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2009-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "CA",
            "license": "7319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE #",
            "identifier": "456414",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE #",
            "identifier": "7319",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Feeling Doctor Psychotherapy, Apc
• Caitlin Patricia Feilzer
• Elisa Sharona Feingold, D.O.
• Elissa Christine Feld
• Avi Feldman, PT
• Kristi Leigh Fenton, AGACNP-BC
• Wilda Elaine Fergunson, MA
• Donna K Ferguson-Compton, PT
• Stefanie Fernandes
• Damian Olivier Fernandez, M.D.

• Obstetrics & Gynecology Nurse Practitioner in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Obstetrics & Gynecology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.