Provider Demographics
NPI:1902233620
Name:FEISTEL, ROSA C (RN, BSN)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:C
Last Name:FEISTEL
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S ELLISON AVE
Mailing Address - Street 2:
Mailing Address - City:EL RENO
Mailing Address - State:OK
Mailing Address - Zip Code:73036-5226
Mailing Address - Country:US
Mailing Address - Phone:405-262-2382
Mailing Address - Fax:
Practice Address - Street 1:900 S ELLISON AVE
Practice Address - Street 2:
Practice Address - City:EL RENO
Practice Address - State:OK
Practice Address - Zip Code:73036-5226
Practice Address - Country:US
Practice Address - Phone:405-262-2382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0064676163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health