Healthcare Provider Details

I. General information

NPI: 1164053757
Provider Name (Legal Business Name): DEBRA FELDERHOFF NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2020
Last Update Date: 08/11/2023
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 11TH STREET
WICHITA FALLS TX
76301-4300
US

IV. Provider business mailing address

1631 11TH STREET UNIT B
WICHITA FALLS TX
76301-4332
US

V. Phone/Fax

Practice location:
  • Phone: 940-263-3000
  • Fax: 940-263-3018
Mailing address:
  • Phone: 940-263-3000
  • Fax: 940-263-3018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP144917
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: