MEDICARE: MRS. ELLEN ANN FERRELL MSN

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	363L00000X	Nurse Practitioner	3015085	KY
2	363LF0000X	Family Nurse Practitioner	RN0000113761	TN

General Provider Information

NPI Number	:	1922093756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELLEN ANN FERRELL MSN

Provider Business Mailing Address
First Line	:	PO BOX 932958
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44193-0028
Country	:	US
Telephone Number	:	615-425-4200
Fax Number	:

Provider Business Practice Location Address
First Line	:	2600 MEMORIAL BLVD
Second Line	:
City	:	SPRINGFIELD
State	:	TN
Zip	:	37172-3925
Country	:	US
Telephone Number	:	615-212-0920
Fax Number	:

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

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	03/31/2025

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