Healthcare Provider Details

I. General information

NPI: 1376115741
Provider Name (Legal Business Name): ALI MARIE FEATHERS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2021
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E PLANK RD
ALTOONA PA
16602-4154
US

IV. Provider business mailing address

1414 9TH AVE
ALTOONA PA
16602-2452
US

V. Phone/Fax

Practice location:
  • Phone: 814-946-3801
  • Fax:
Mailing address:
  • Phone: 814-946-1655
  • Fax: 814-949-7640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberOA005669
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOA005669
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMA062565
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: