Healthcare Provider Details

I. General information

NPI: 1144609801
Provider Name (Legal Business Name): DEANNA MARIE FELVEY NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2015
Last Update Date: 02/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 GREEN ST STE 306
AUGUSTA ME
04330-7411
US

IV. Provider business mailing address

9 GREEN ST
AUGUSTA ME
04330-7451
US

V. Phone/Fax

Practice location:
  • Phone: 207-622-4500
  • Fax:
Mailing address:
  • Phone: 207-777-3399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN54490
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberCNP151052
License Number StateME
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberCNP151052
License Number StateME
# 4
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberCNP151052
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: