Healthcare Provider Details

I. General information

NPI: 1740595727
Provider Name (Legal Business Name): THERESA B FEINER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2010
Last Update Date: 08/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 PARK AVE SE
AIKEN SC
29801-4515
US

IV. Provider business mailing address

721 PARK AVE SE
AIKEN SC
29801-4515
US

V. Phone/Fax

Practice location:
  • Phone: 803-522-5281
  • Fax:
Mailing address:
  • Phone: 803-522-5281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberR105768
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: