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Individual

ELLEN MARIE FEEHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, BSN, CWOCN

Contact information

Practice address
13381 W ACORN ST, BOISE, ID 83713-0873
(815) 997-7627
Mailing address
13381 W ACORN ST, BOISE, ID 83713-0873
(815) 997-7627

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704290285
MI
163WW0000X
Wound Care Registered Nurse
2005455305
MN
163WW0000X
Wound Care Registered Nurse
Primary
N-43041
ID

Other

Enumeration date
03/23/2013
Last updated
03/23/2013
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