MEDICARE: JUSTIN FELDSCHAU MSN FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	730605	TX
2	363LF0000X	Family Nurse Practitioner	AP131554	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396198669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTIN FELDSCHAU MSN FNP-C

Provider Business Mailing Address
First Line	:	2929 CALDER ST
Second Line	:	SUITE 100
City	:	BEAUMONT
State	:	TX
Zip	:	77702-1845
Country	:	US
Telephone Number	:	409-833-9797
Fax Number	:	409-654-6886

Provider Business Practice Location Address
First Line	:	2501 JIMMY JOHNSON BLVD STE 501A
Second Line	:
City	:	PORT ARTHUR
State	:	TX
Zip	:	77640-2013
Country	:	US
Telephone Number	:	409-833-9797
Fax Number	:	409-654-6912

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2016
Last Update Date	:	06/06/2022

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