Provider Demographics
NPI:1366470130
Name:FELTEN, BEVERLY (NP)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
Last Name:FELTEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:DR
Other - First Name:BEVERLY
Other - Middle Name:SIGL
Other - Last Name:FELTEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, RN, APNP
Mailing Address - Street 1:5555 N. 51ST BLVD.
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218
Mailing Address - Country:US
Mailing Address - Phone:414-527-6970
Mailing Address - Fax:414-527-6971
Practice Address - Street 1:5555 N. 51ST BLVD.
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218
Practice Address - Country:US
Practice Address - Phone:414-527-6970
Practice Address - Fax:414-527-6971
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4-033364SG0600X
WI4-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology