Provider Demographics
NPI:1417918194
Name:FERRIELL, JUDITH K (CNP)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:K
Last Name:FERRIELL
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33633 N 12TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-7711
Mailing Address - Country:US
Mailing Address - Phone:623-582-6238
Mailing Address - Fax:
Practice Address - Street 1:1 E APACHE ST
Practice Address - Street 2:
Practice Address - City:WICKENBURG
Practice Address - State:AZ
Practice Address - Zip Code:85390-2442
Practice Address - Country:US
Practice Address - Phone:928-684-4320
Practice Address - Fax:928-684-4548
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN115494363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner