Basic Information
| Provider Information | |||||||||
| NPI: | 1982770616 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FELDMAN | ||||||||
| FirstName: | LAURIE | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | FNP RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 107 PARMAC ROAD SUITE 2 | ||||||||
| Address2: | |||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308912784 | ||||||||
| FaxNumber: | 5308912809 | ||||||||
| Practice Location | |||||||||
| Address1: | 107 PARMAC ROAD | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308912784 | ||||||||
| FaxNumber: | 5308912809 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/27/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | RN397526 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | MF0967173 | 01 | CA | DEA | OTHER | NPF8534 | 01 | CA | BRN | OTHER |