Provider Demographics
NPI:1124412341
Name:FEATHERSTON, AMY (NP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:FEATHERSTON
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:ELIZABETH
Other - Last Name:CHARBA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3570 COLLEGE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-4679
Mailing Address - Country:US
Mailing Address - Phone:409-554-0545
Mailing Address - Fax:409-554-0921
Practice Address - Street 1:3570 COLLEGE ST STE 200
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4679
Practice Address - Country:US
Practice Address - Phone:409-554-0545
Practice Address - Fax:409-554-0921
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127699363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP127699OtherNP LICENSE