Healthcare Provider Details

I. General information

NPI: 1962110585
Provider Name (Legal Business Name): JACQUELINE FEIST PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2022
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 CENTRAL PARK DR
STEAMBOAT SPRINGS CO
80487-3570
US

IV. Provider business mailing address

931 S SAGINAW RD
MIDLAND MI
48640-4602
US

V. Phone/Fax

Practice location:
  • Phone: 970-879-7317
  • Fax:
Mailing address:
  • Phone: 989-631-0910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number5302414442
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number00251100
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: