Provider Demographics
NPI:1477787521
Name:LOWENSTEIN-MOFFETT, FELICIA ANTOINETTE (FNP, MSN)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:ANTOINETTE
Last Name:LOWENSTEIN-MOFFETT
Suffix:
Gender:F
Credentials:FNP, MSN
Other - Prefix:
Other - First Name:FELICIA
Other - Middle Name:L
Other - Last Name:MOFFETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP, MSN, PHN
Mailing Address - Street 1:850 HARVARD WAY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-2055
Mailing Address - Country:US
Mailing Address - Phone:775-982-5262
Mailing Address - Fax:775-982-5496
Practice Address - Street 1:975 RYLAND ST STE 100
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1669
Practice Address - Country:US
Practice Address - Phone:775-982-5000
Practice Address - Fax:775-982-5225
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN001494363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
12510151OtherCAQH
NV1477787521Medicaid
NVHC866XMedicare PIN
NVV110346Medicare PIN
12510151OtherCAQH