Provider Demographics
NPI:1306536537
Name:FELDMAN, YVETTE MICHELLE (RN, MSN, ACCNS-P)
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:MICHELLE
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:RN, MSN, ACCNS-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1332 W SIX SHOOTER ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:ID
Mailing Address - Zip Code:83644-6205
Mailing Address - Country:US
Mailing Address - Phone:916-397-2560
Mailing Address - Fax:
Practice Address - Street 1:1332 W SIX SHOOTER ST
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:ID
Practice Address - Zip Code:83644-6205
Practice Address - Country:US
Practice Address - Phone:916-397-2560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA540077163WP0200X
ID69838163WP0200X, 364SP0200X
CA4929364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics