1417022294 NPI number — MS. ANN MARIE FELAUER APNP, CPNP

Table of content: MS. ANN MARIE FELAUER APNP, CPNP (NPI 1417022294)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417022294 NPI number — MS. ANN MARIE FELAUER APNP, CPNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FELAUER
Provider First Name:
ANN
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
APNP, CPNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417022294
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/21/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
655 W LOMBARD STREET
Provider Second Line Business Mailing Address:
SUITE 575C
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21201-4837
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-706-1501
Provider Business Mailing Address Fax Number:
410-706-0253

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
655 W LOMBARD STREET
Provider Second Line Business Practice Location Address:
SUITE 575C
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21201-4837
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-706-1501
Provider Business Practice Location Address Fax Number:
410-706-0253
Provider Enumeration Date:
11/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0222X , with the licence number:  2268 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0222X , with the licence number: R169295 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 43993500 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com