Provider Demographics
NPI:1427037290
Name:FEDDES, CINDY K (FNP)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:K
Last Name:FEDDES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1188 N 15TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3290
Mailing Address - Country:US
Mailing Address - Phone:406-582-1111
Mailing Address - Fax:406-582-1112
Practice Address - Street 1:1188 N 15TH AVE STE 3
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3290
Practice Address - Country:US
Practice Address - Phone:406-582-1111
Practice Address - Fax:406-582-1112
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT28869363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P82272Medicare UPIN
84958Medicare ID - Type Unspecified