Provider Demographics
NPI:1649652843
Name:FEUCHT, ELIZABETH ANNE (APRN)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANNE
Last Name:FEUCHT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:ANNE
Other - Last Name:HIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:8258 GENTRY ST NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-8729
Mailing Address - Country:US
Mailing Address - Phone:330-524-2884
Mailing Address - Fax:
Practice Address - Street 1:4600 BOHANNON DR STE 100
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-1037
Practice Address - Country:US
Practice Address - Phone:209-677-7468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-24
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.17476363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology