Provider Demographics
NPI:1861421166
Name:FEYOCK, FRANCIS PATRICK (CRNA)
Entity type:Individual
Prefix:MR
First Name:FRANCIS
Middle Name:PATRICK
Last Name:FEYOCK
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1234 LUZERNE STREET EXT
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-2153
Mailing Address - Country:US
Mailing Address - Phone:814-255-2264
Mailing Address - Fax:
Practice Address - Street 1:1234 LUZERNE STREET EXT
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-2153
Practice Address - Country:US
Practice Address - Phone:814-255-2264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-01
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN238251L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA017029Medicare PIN
PAS63015Medicare UPIN