Provider Demographics
NPI:1902453749
Name:FELDGES, JOANN (RN, QMHP)
Entity Type:Individual
Prefix:MS
First Name:JOANN
Middle Name:
Last Name:FELDGES
Suffix:
Gender:F
Credentials:RN, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 UNION ST
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:60450-2426
Mailing Address - Country:US
Mailing Address - Phone:815-941-3404
Mailing Address - Fax:815-941-2389
Practice Address - Street 1:1320 UNION ST
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:IL
Practice Address - Zip Code:60450-2426
Practice Address - Country:US
Practice Address - Phone:815-941-3404
Practice Address - Fax:815-941-2389
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.264298163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health