Provider Demographics
NPI:1578156949
Name:FERRIS, NOELLE CHRISTINE (RN)
Entity Type:Individual
Prefix:MISS
First Name:NOELLE
Middle Name:CHRISTINE
Last Name:FERRIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:BERGEN
Mailing Address - State:NY
Mailing Address - Zip Code:14416-9771
Mailing Address - Country:US
Mailing Address - Phone:585-297-2564
Mailing Address - Fax:
Practice Address - Street 1:13 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:BERGEN
Practice Address - State:NY
Practice Address - Zip Code:14416-9771
Practice Address - Country:US
Practice Address - Phone:585-297-2564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY750919163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics