Healthcare Provider Details
I. General information
NPI: 1821980459
Provider Name (Legal Business Name): EDDIE TRAVIS FEAGIN DNP, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/17/2025
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3910 WASHINGTON RD
AUGUSTA GA
30907-2349
US
IV. Provider business mailing address
2295 HENRY TECKLENBURG DR
CHARLESTON SC
29414-7801
US
V. Phone/Fax
- Phone: 706-664-0767
- Fax:
- Phone: 843-766-7103
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 30568 |
| License Number State | SC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | GAA-NP003784 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: