Provider Demographics
NPI:1316988991
Name:FELTER, STEPHEN W (CRNA)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:W
Last Name:FELTER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 20452
Mailing Address - Street 2:YPS CREDENTIALING
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-0452
Mailing Address - Country:US
Mailing Address - Phone:614-442-2406
Mailing Address - Fax:614-442-2410
Practice Address - Street 1:800 HIGHWAY 71 E
Practice Address - Street 2:C/O SETON-SMITHVILLE REGIONAL HOSPITAL
Practice Address - City:SMITHVILLE
Practice Address - State:TX
Practice Address - Zip Code:78957-1730
Practice Address - Country:US
Practice Address - Phone:512-237-3214
Practice Address - Fax:512-237-5768
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX571772367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8871UBOtherBCBS OF TX
TX142952404Medicaid
TX571772OtherSTATE LICENSE NUMBER
TX571772OtherSTATE LICENSE NUMBER
8G4018Medicare UPIN