Provider Demographics
NPI:1417022294
Name:FELAUER, ANN MARIE (APNP, CPNP)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:MARIE
Last Name:FELAUER
Suffix:
Gender:F
Credentials:APNP, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 W LOMBARD STREET
Mailing Address - Street 2:SUITE 575C
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-4837
Mailing Address - Country:US
Mailing Address - Phone:410-706-1501
Mailing Address - Fax:410-706-0253
Practice Address - Street 1:655 W LOMBARD STREET
Practice Address - Street 2:SUITE 575C
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-4837
Practice Address - Country:US
Practice Address - Phone:410-706-1501
Practice Address - Fax:410-706-0253
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2268363LP0222X
MDR169295363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43993500Medicaid
WI43993500Medicaid