Healthcare Provider Details

I. General information

NPI: 1649770850
Provider Name (Legal Business Name): MARY FERRALL NEY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY ELIZABETH FERRALL

II. Dates (important events)

Enumeration Date: 02/14/2018
Last Update Date: 04/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4061 INDIAN CREEK PKWY
OVERLAND PARK KS
66207-4030
US

IV. Provider business mailing address

901 E 104TH ST MAILSTOP 400
KANSAS CITY MO
64131
US

V. Phone/Fax

Practice location:
  • Phone: 913-323-8885
  • Fax: 913-323-8886
Mailing address:
  • Phone: 816-599-9499
  • Fax: 816-932-9670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number2010025650
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-78091
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: