Blossom Mandy Felicien, MA

Primary specialty

Basic Emergency Medical TechnicianTaxonomy code 146N00000X

License

2900134 Issued in WI

Practice address

2323 S 109TH St Ste 130B
West Allis, WI 53227-1909

Phone

(414) 334-5224

NPI assigned

May 4, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1651622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1740925601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 S 109TH ST STE 130B",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532271909",
            "telephone_number": "414-334-5224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 S 109TH ST STE 130B",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532271909",
            "telephone_number": "414-334-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELICIEN",
        "first_name": "BLOSSOM",
        "middle_name": "MANDY",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-04",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "WI",
            "license": "2900134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Blossomspca@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2323 S 109th St Ste 130B",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532271909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ayesha Farooq, MBBS
• Janai Aleice Farr, LPC-IT
• Aisha Fatima
• Ashley Lauren Faytol
• Daniel Fecht, PT
• Debra L Felzer, RN
• Cori Fendt, LCSW, SAC-IT
• Daniel Ferguson, M.D.
• McKayla Figueroa, PT, DPT, ATC
• Jessica Finch

• Basic Emergency Medical Technician in West Allis, WI
• Providers in West Allis, WI by specialty
• Basic Emergency Medical Technician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; 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.