Provider Demographics
NPI:1548528755
Name:FELGENHAUER, BARBARA L (FNP-BC)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:L
Last Name:FELGENHAUER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 268
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:IL
Mailing Address - Zip Code:61032-0268
Mailing Address - Country:US
Mailing Address - Phone:815-599-7950
Mailing Address - Fax:
Practice Address - Street 1:555 W SOUTH ST
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:IL
Practice Address - Zip Code:61032-6792
Practice Address - Country:US
Practice Address - Phone:815-599-7801
Practice Address - Fax:815-599-7802
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209009487363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily