MEDICARE: ANGELA SMITH FELTZ FNP-C

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	363LF0000X	Family Nurse Practitioner	4704216442	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	5008614480	OTHER	MI	BCBS IND

General Provider Information

NPI Number	:	1851502785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA SMITH FELTZ FNP-C

Provider Business Mailing Address
First Line	:	1161 QUEENS DR
Second Line	:
City	:	OXFORD
State	:	MI
Zip	:	48371-5919
Country	:	US
Telephone Number	:	248-969-0032
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 TORREY RD
Second Line	:	300
City	:	FENTON
State	:	MI
Zip	:	48430-3327
Country	:	US
Telephone Number	:	810-714-7369
Fax Number	:	810-714-9258

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

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	08/10/2011

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