Provider Demographics
NPI:1114543386
Name:FELTZ, CHEYENNE JAE (PMHNP, APRN)
Entity Type:Individual
Prefix:
First Name:CHEYENNE
Middle Name:JAE
Last Name:FELTZ
Suffix:
Gender:F
Credentials:PMHNP, APRN
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 1391
Mailing Address - Street 2:
Mailing Address - City:FORT BENTON
Mailing Address - State:MT
Mailing Address - Zip Code:59442-1391
Mailing Address - Country:US
Mailing Address - Phone:505-362-8212
Mailing Address - Fax:
Practice Address - Street 1:166 MONTANA AVE E
Practice Address - Street 2:
Practice Address - City:BIG SANDY
Practice Address - State:MT
Practice Address - Zip Code:59520-7754
Practice Address - Country:US
Practice Address - Phone:406-378-2189
Practice Address - Fax:406-378-2180
Is Sole Proprietor?:No
Enumeration Date:2020-06-23
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-217333363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health