MEDICARE: MRS. LAURIE ANN FERRARO RN, GNP

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	363LG0600X	Gerontology Nurse Practitioner	690576	TX

General Provider Information

NPI Number	:	1720310436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LAURIE ANN FERRARO RN, GNP

Provider Business Mailing Address
First Line	:	4509 NORMAN TRL
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78749-1154
Country	:	US
Telephone Number	:	512-225-6345
Fax Number	:	512-692-5205

Provider Business Practice Location Address
First Line	:	4509 NORMAN TRL
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78749-1154
Country	:	US
Telephone Number	:	512-225-6345
Fax Number	:	512-692-5205

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

Provider Enumeration Date	:	02/04/2010
Last Update Date	:	01/31/2013

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