Provider Demographics
NPI:1124565015
Name:FEEHAN, TAYLOR M (PA-C)
Entity Type:Individual
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First Name:TAYLOR
Middle Name:M
Last Name:FEEHAN
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:10020 NICHOLAS ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2189
Mailing Address - Country:US
Mailing Address - Phone:402-397-8040
Mailing Address - Fax:402-397-8558
Practice Address - Street 1:10020 NICHOLAS ST
Practice Address - Street 2:SUITE 105
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2189
Practice Address - Country:US
Practice Address - Phone:402-397-8040
Practice Address - Fax:402-397-8558
Is Sole Proprietor?:No
Enumeration Date:2017-01-30
Last Update Date:2017-06-14
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Provider Licenses
StateLicense IDTaxonomies
NE2089363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant