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NPI Code Detail

MEDICARE: CONNIE FERRELL

MEDICARE: CONNIE FERRELL
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
1225X00000XOccupational Therapist1718AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AZ0140920OTHERAZBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881720498
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONNIE FERRELL
Provider Business Mailing Address
First Line : 2850 N 24TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85008-1004
Country : US
Telephone Number : 602-266-5976
Fax Number : 602-274-8952
Provider Business Practice Location Address
First Line : 2850 N 24TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85008-1004
Country : US
Telephone Number : 602-266-5976
Fax Number : 602-274-8952
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2007
Last Update Date : 07/09/2007

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Directions to “ CONNIE FERRELL ” Practice Location

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