Provider Demographics
NPI:1093256695
Name:FEIDT, VICTORIA C (CRNP)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:C
Last Name:FEIDT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:C
Other - Last Name:DAUBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:3301 TRINDLE RD
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-4413
Mailing Address - Country:US
Mailing Address - Phone:717-412-7859
Mailing Address - Fax:717-965-3214
Practice Address - Street 1:3301 TRINDLE RD
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4413
Practice Address - Country:US
Practice Address - Phone:717-412-7859
Practice Address - Fax:717-965-3214
Is Sole Proprietor?:No
Enumeration Date:2017-03-15
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP017203363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103274772Medicaid
PA568750Medicare PIN