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NPI Code Detail

MEDICARE: SHEREE FEDDER NNP

MEDICARE: SHEREE FEDDER NNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LN0000XNeonatal Nurse PractitionerAP118747TX

General Provider Information

NPI Number : 1255304135
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHEREE FEDDER NNP
Provider Business Mailing Address
First Line : PO BOX 844658
Second Line :
City : DALLAS
State : TX
Zip : 75284-4658
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 700 SCOTT AND WHITE DR
Second Line :
City : COLLEGE STATION
State : TX
Zip : 77845-6441
Country : US
Telephone Number : 979-207-0100
Fax Number : 979-207-2161
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2006
Last Update Date : 12/09/2021

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