| Doctor Name: | AUTUMN L. FEAZELL |
| NPI Number: | 1134493125 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-BC |
| License Number: | 61562 |
| Business Practice Address: | 908 Scarbro Road Scarbro, WV - 25917 |
| Business Phone Number: | 3044692905 |
| Business Fax Number: | 3044653180 |
| Mailing Address: | Po Box 337, SCARBRO |
| State: | WV |
| Postal Code: | 259170337 |
| Phone Number: | 3044692905 |
| Fax Number: | 3044655486 |
| NPI Enumeration Date: | 03/08/2012 |
| NPI Last Update Date: | 10/20/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 61562 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WV |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |