Healthcare Provider Details
I. General information
NPI: 1780168377
Provider Name (Legal Business Name): CARRIE B FERREL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/19/2018
Last Update Date: 03/10/2022
Certification Date: 03/10/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
575 INDUSTRIAL DR
LOUISA VA
23093-4146
US
IV. Provider business mailing address
PO BOX 9007
CHARLOTTESVILLE VA
22906-9007
US
V. Phone/Fax
- Phone: 540-967-2011
- Fax: 540-967-2982
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | 0019004634 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 0024176569 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: