Provider Demographics
NPI:1962614255
Name:KEARNEY, FELICIA D (FNP)
Entity type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:D
Last Name:KEARNEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20770 US HIGHWAY 281 N # 108-439
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-7655
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:972-253-4218
Practice Address - Street 1:1401 E TRINITY MILLS RD FL 3
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006
Practice Address - Country:US
Practice Address - Phone:210-802-4662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX607246363LF0000X
TXAP115766363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB140062OtherGROUP PTAN
TX184795604Medicaid
TX2035487-04OtherGROUP TPI
TX809N14OtherBCBS
TX184795603Medicaid
TX1847956-06Medicaid
TX184795605Medicaid
TX184795605Medicaid
TX184795604Medicaid
TXTXB137516Medicare PIN
TXTXB140062OtherGROUP PTAN
TX326311YNVLMedicare PIN