Provider Demographics
NPI:1003248576
Name:FERRARO, MERISSA ANNE (AGNP-BC)
Entity Type:Individual
Prefix:MS
First Name:MERISSA
Middle Name:ANNE
Last Name:FERRARO
Suffix:
Gender:F
Credentials:AGNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5717 PACIFIC CENTER BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-4250
Mailing Address - Country:US
Mailing Address - Phone:858-859-1188
Mailing Address - Fax:844-404-8924
Practice Address - Street 1:5717 PACIFIC CENTER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-4250
Practice Address - Country:US
Practice Address - Phone:858-859-1188
Practice Address - Fax:844-404-8924
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2013001175363LA2200X
CA1003248576363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health