Provider Demographics
NPI:1053680801
Name:FELDMAN, NAN SHERRYL (RN)
Entity Type:Individual
Prefix:MRS
First Name:NAN
Middle Name:SHERRYL
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 POND PATH
Mailing Address - Street 2:
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-1161
Mailing Address - Country:US
Mailing Address - Phone:631-730-4410
Mailing Address - Fax:631-730-4413
Practice Address - Street 1:490 POND PATH
Practice Address - Street 2:
Practice Address - City:SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-1161
Practice Address - Country:US
Practice Address - Phone:631-730-4410
Practice Address - Fax:631-730-4413
Is Sole Proprietor?:No
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY459372-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse