Provider Demographics
NPI:1033228861
Name:FELTNER, SARA L (FNPC)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:L
Last Name:FELTNER
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1461 N GARDNER ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47170
Mailing Address - Country:US
Mailing Address - Phone:812-752-4656
Mailing Address - Fax:812-752-4919
Practice Address - Street 1:1461 N GARDNER ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBURG
Practice Address - State:IN
Practice Address - Zip Code:47170
Practice Address - Country:US
Practice Address - Phone:812-752-4656
Practice Address - Fax:812-752-4919
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001049363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P38039Medicare UPIN
INM900066129Medicare PIN