MEDICARE: MRS. DAN FENG APRN

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
1	364SA2200X	Adult Health Clinical Nurse Specialist	734502	TX

General Provider Information

NPI Number	:	1326272477
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DAN FENG APRN

Provider Business Mailing Address
First Line	:	11250 TAYLOR DRAPER LN APT 734
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-3977
Country	:	US
Telephone Number	:	512-239-9463
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 S AUSTIN AVE
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78626-5610
Country	:	US
Telephone Number	:	512-868-9078
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2009
Last Update Date	:	05/04/2009

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