Healthcare Provider Details

I. General information

NPI: 1972155182
Provider Name (Legal Business Name): BRITTANY NICOLE FELDHAUS LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2019
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 E ROSS AVE
SAPULPA OK
74066-6423
US

IV. Provider business mailing address

27 E ROSS AVE
SAPULPA OK
74066-6423
US

V. Phone/Fax

Practice location:
  • Phone: 918-216-4999
  • Fax: 918-216-4998
Mailing address:
  • Phone: 918-216-4999
  • Fax: 918-216-4998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number220739
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number701227
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: