MEDICARE: JOSEPH P FERO NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	R588067	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	84-1670761	OTHER		TAX ID #

General Provider Information

NPI Number	:	1669457925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH P FERO NP

Provider Business Mailing Address
First Line	:	12313 HIGHWAY 57
Second Line	:
City	:	VANCLEAVE
State	:	MS
Zip	:	39565-9501
Country	:	US
Telephone Number	:	228-826-1990
Fax Number	:	228-826-1998

Provider Business Practice Location Address
First Line	:	12313 HIGHWAY 57
Second Line	:
City	:	VANCLEAVE
State	:	MS
Zip	:	39565-9501
Country	:	US
Telephone Number	:	228-826-1990
Fax Number	:	228-826-1998

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	10/16/2014

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Directions to “ JOSEPH P FERO NP” Practice Location

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