Basic Information
| Provider Information | |||||||||
| NPI: | 1659606267 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FEIST | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | A.P.N | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1007 NW 3RD ST | ||||||||
| Address2: | |||||||||
| City: | ALEDO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 612311317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3095829450 | ||||||||
| FaxNumber: | 3095829479 | ||||||||
| Practice Location | |||||||||
| Address1: | 1007 NW 3RD ST | ||||||||
| Address2: | |||||||||
| City: | ALEDO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 612311317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3093095829 | ||||||||
| FaxNumber: | 3095829479 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/15/2009 | ||||||||
| LastUpdateDate: | 05/13/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | L-111778 | IA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | 363LA2100X | 209007778 | IL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | 363L00000X | 209007778 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.