Provider Demographics
NPI:1619606431
Name:FERRELL, KAREN DENISE
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:DENISE
Last Name:FERRELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 FAIRWAY DR APT 1927
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-6792
Mailing Address - Country:US
Mailing Address - Phone:512-773-7268
Mailing Address - Fax:
Practice Address - Street 1:770 FAIRWAY DR APT 1927
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-6792
Practice Address - Country:US
Practice Address - Phone:512-773-7268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator