Provider Demographics
NPI:1982770616
Name:FELDMAN, LAURIE ANNE (FNP RN)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:ANNE
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:FNP RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 PARMAC ROAD SUITE 2
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926
Mailing Address - Country:US
Mailing Address - Phone:530-891-2784
Mailing Address - Fax:530-891-2809
Practice Address - Street 1:107 PARMAC ROAD
Practice Address - Street 2:SUITE 2
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926
Practice Address - Country:US
Practice Address - Phone:530-891-2784
Practice Address - Fax:530-891-2809
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN397526363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANPF8534OtherBRN
CANPF8534OtherBRN
CAMF0967173OtherDEA
CAZZZ27216ZMedicare ID - Type Unspecified