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General NPI Number Information
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NPI Number | 1467451781
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Entity Type | Individual
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Provider Name | JEANETTE MARIE FEUCHT MSN CNP
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Gender | Female
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 1505 EASTLAND DR SUITE 220
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City | BLOOMINGTON
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State | IL
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Zip | 61701
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Country | US
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Telephone | 309-585-0370
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Fax | 309-663-2956
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Provider Business Mailing Address
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Address Line | 611 W. PARK ST. FAPC
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City | URBANA
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State | IL
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Zip | 61801
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 018212
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209-005113
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License Number State | IL
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