Provider Demographics
NPI:1699213702
Name:FELDERHOFF, SARAH (FNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:FELDERHOFF
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:CANALS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1500 S LAMAR BLVD
Mailing Address - Street 2:APT. 3007
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-2940
Mailing Address - Country:US
Mailing Address - Phone:936-499-9042
Mailing Address - Fax:
Practice Address - Street 1:1500 S LAMAR BLVD
Practice Address - Street 2:APT. 3007
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-2940
Practice Address - Country:US
Practice Address - Phone:936-499-9042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-09
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133248363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX563601YMGJOtherMEDICARE
TX370225001Medicaid