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NPI Code Detail

MEDICARE: MS. CHRISTINE B. FERRELLE NP

MEDICARE: MS. CHRISTINE B. FERRELLE 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
1363L00000XNurse PractitionerRN052324GA
2363LP0200XPediatric Nurse PractitionerRN052324GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110064966OTHERAMERIGROUP
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114080405
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHRISTINE B. FERRELLE NP
Provider Business Mailing Address
First Line : 106 E BROAD ST
Second Line :
City : SAVANNAH
State : GA
Zip : 31401-2917
Country : US
Telephone Number : 912-527-1000
Fax Number :
Provider Business Practice Location Address
First Line : 2 ROBERTS ST
Second Line :
City : SAVANNAH
State : GA
Zip : 31408-3524
Country : US
Telephone Number : 912-527-1100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2006
Last Update Date : 07/19/2021

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