Provider Demographics
NPI:1609900836
Name:FERRIS, MADONNA L (APRN-BC-FNP)
Entity Type:Individual
Prefix:
First Name:MADONNA
Middle Name:L
Last Name:FERRIS
Suffix:
Gender:F
Credentials:APRN-BC-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3711 N EVERBROOK LN
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-5270
Mailing Address - Country:US
Mailing Address - Phone:765-287-8593
Mailing Address - Fax:765-287-8593
Practice Address - Street 1:601 BUSINESS LOOP 70 W
Practice Address - Street 2:STE 275
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-2585
Practice Address - Country:US
Practice Address - Phone:573-874-0008
Practice Address - Fax:573-875-5350
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71009895A363LF0000X
MO129711363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily