Healthcare Provider Details

I. General information

NPI: 1134166424
Provider Name (Legal Business Name): STACY LYN FERRERI CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STACY LYN ADAMS CRNA

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 06/30/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9701 VENTNOR AVE STE 201
MARGATE CITY NJ
08402-2222
US

IV. Provider business mailing address

111 ROCHELLE LN
EGG HARBOR TOWNSHIP NJ
08234-7646
US

V. Phone/Fax

Practice location:
  • Phone: 609-822-4242
  • Fax: 609-822-3211
Mailing address:
  • Phone: 610-755-7037
  • Fax: 609-904-6114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR11294000
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number75015
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN524736L
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number26NJ00457100
License Number StateNJ
# 5
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11017812
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: