Healthcare Provider Details

I. General information

NPI: 1275976938
Provider Name (Legal Business Name): JANETTE MAE FEUERSTEIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2013
Last Update Date: 04/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1188 HAMPTON ROAD
REEDS SPRING MO
65737
US

IV. Provider business mailing address

1188 HAMPTON ROAD
REEDS SPRING MO
65737
US

V. Phone/Fax

Practice location:
  • Phone: 417-334-9444
  • Fax:
Mailing address:
  • Phone: 417-334-9444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2005032431
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: