Provider Demographics
NPI:1932259652
Name:FEASTER, ANNE E (CRNP)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:E
Last Name:FEASTER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 LANGHORNE NEWTOWN RD
Mailing Address - Street 2:SUITE 135
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1209
Mailing Address - Country:US
Mailing Address - Phone:215-750-5050
Mailing Address - Fax:215-750-6514
Practice Address - Street 1:1203 LANGHORNE NEWTOWN RD
Practice Address - Street 2:SUITE 135
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1209
Practice Address - Country:US
Practice Address - Phone:215-750-5050
Practice Address - Fax:215-750-6514
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP005063C363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS86268Medicare UPIN
PA029642Medicare ID - Type Unspecified