Provider Demographics
NPI:1114092079
Name:FELTZIN, JOYA H (CNM FNP)
Entity Type:Individual
Prefix:MS
First Name:JOYA
Middle Name:H
Last Name:FELTZIN
Suffix:
Gender:F
Credentials:CNM FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1020
Mailing Address - Street 2:
Mailing Address - City:CAVE JUNCTION
Mailing Address - State:OR
Mailing Address - Zip Code:97523
Mailing Address - Country:US
Mailing Address - Phone:541-592-4619
Mailing Address - Fax:
Practice Address - Street 1:625 E RIVER STREET
Practice Address - Street 2:ILLINOIS VALLEY HIGH SCHOOL STUDENT HEALTH CENTER
Practice Address - City:CAVE JUNCTION
Practice Address - State:OR
Practice Address - Zip Code:97523
Practice Address - Country:US
Practice Address - Phone:541-592-3749
Practice Address - Fax:541-592-3749
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR076036673N1FNPPP363L00000X
OR076036673N5NMNP367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Not Answered367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR022223Medicaid