=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982770616
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LAURIE ANNE FELDMAN FNP RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/27/2006
-----------------------------------------------------
Last Update Date | 03/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 107 PARMAC ROAD SUITE 2
-----------------------------------------------------
City | CHICO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95926
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-891-2784
-----------------------------------------------------
Fax | 530-891-2809
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 107 PARMAC ROAD SUITE 2
-----------------------------------------------------
City | CHICO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95926
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-891-2784
-----------------------------------------------------
Fax | 530-891-2809
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | RN397526
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------