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General NPI Number Information
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NPI Number | 1649652843
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Entity Type | Individual
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Provider Name | ELIZABETH ANNE FEUCHT APRN
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Gender | Female
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Dates
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Enumeration Date | 06/24/2015
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 4600 BOHANNON DR STE 100
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City | MENLO PARK
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State | CA
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Zip | 94025-1037
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Country | US
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Telephone | 209-677-7468
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Fax |
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Provider Business Mailing Address
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Address Line | 8258 GENTRY ST NW
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City | MASSILLON
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State | OH
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Zip | 44646-8729
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Country | US
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Telephone | 330-524-2884
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | APRN.CNP.17476
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN.CNP.17476
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License Number State | OH
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