Provider Demographics
NPI:1154869345
Name:FIELDER, NOELLE ELIZABETH (LAT, ATC)
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:ELIZABETH
Last Name:FIELDER
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:NOELLE
Other - Middle Name:ELIZABETH
Other - Last Name:VADEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 SE BLUE PKWY
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 SE BLUE PKWY
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-4352
Practice Address - Country:US
Practice Address - Phone:816-708-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program