Healthcare Provider Details

I. General information

NPI: 1841511334
Provider Name (Legal Business Name): REBECCA FEYDER CD(DONA)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2010
Last Update Date: 06/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

983 AVON ST N
SAINT PAUL MN
55103-1301
US

IV. Provider business mailing address

983 AVON ST N
SAINT PAUL MN
55103-1301
US

V. Phone/Fax

Practice location:
  • Phone: 651-442-0653
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: