Individual
JENNIFER MARIE FEAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-3541
(336) 713-8250
(336) 713-8588
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 713-8250
(336) 713-8588
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN60741442
WA
363L00000X
Nurse Practitioner
Primary
5014797
NC
363LA2100X
Acute Care Nurse Practitioner
5014797
NC
Other
Enumeration date
02/21/2020
Last updated
10/08/2021
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