Provider Demographics
NPI:1982895736
Name:FEATHERSTON, ELISHIA LANNETTE (DNP, APRN, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:ELISHIA
Middle Name:LANNETTE
Last Name:FEATHERSTON
Suffix:
Gender:F
Credentials:DNP, APRN, CPNP-PC
Other - Prefix:
Other - First Name:ELISHIA
Other - Middle Name:LANNETTE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RNCPNP
Mailing Address - Street 1:323 WESTPARK WAY
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-3902
Mailing Address - Country:US
Mailing Address - Phone:682-253-5437
Mailing Address - Fax:817-210-4957
Practice Address - Street 1:323 WESTPARK WAY
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76040-3902
Practice Address - Country:US
Practice Address - Phone:682-253-5437
Practice Address - Fax:817-210-4957
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX692736363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX203823403Medicaid
TX203823404Medicaid
TX203823404Medicaid
TX8L17907Medicare PIN