MEDICARE: LATONYA S FERRELL RN

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	164W00000X	Licensed Practical Nurse	LPN097321	GA
2	163W00000X	Registered Nurse	RN317592	GA

General Provider Information

NPI Number	:	1316616394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATONYA S FERRELL RN

Provider Business Mailing Address
First Line	:	1520 CLIFTON RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-4201
Country	:	US
Telephone Number	:	706-466-9313
Fax Number	:

Provider Business Practice Location Address
First Line	:	1520 CLIFTON RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-5209
Country	:	US
Telephone Number	:	706-466-9313
Fax Number	:

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

Provider Enumeration Date	:	09/13/2021
Last Update Date	:	06/30/2025

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