Provider Demographics
NPI:1457681835
Name:FECUNDO, MARIA ASTRA FELECIA (ARNP)
Entity Type:Individual
Prefix:MISS
First Name:MARIA ASTRA
Middle Name:FELECIA
Last Name:FECUNDO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 LAUREL ST STE 2350
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-3026
Mailing Address - Country:US
Mailing Address - Phone:515-280-4700
Mailing Address - Fax:515-280-4701
Practice Address - Street 1:411 LAUREL ST STE 2350
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-3026
Practice Address - Country:US
Practice Address - Phone:515-280-4700
Practice Address - Fax:515-280-4701
Is Sole Proprietor?:No
Enumeration Date:2010-01-06
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.360387163W00000X
IAH161918363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse