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Individual

JEANETTE MARIE FEUCHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN CNP

Contact information

Practice address
1505 EASTLAND DR, SUITE 220, BLOOMINGTON, IL 61701
(309) 585-0370
(309) 663-2956
Mailing address
611 W. PARK ST., FAPC, URBANA, IL 61801

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-005113
IL
363LF0000X
Family Nurse Practitioner
018212
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
833120
MEDICARE GROUP #
01
CA2264
RR MEDICARE GROUP #
01
P00761350
RR MEDICARE INDIVIDUAL #
Enumeration date
07/19/2005
Last updated
08/12/2025
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