Provider Demographics
NPI:1851563225
Name:FERRIS, ANGELA SUE (DC, RN)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:SUE
Last Name:FERRIS
Suffix:
Gender:F
Credentials:DC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 EMERALD DR
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52804-3006
Mailing Address - Country:US
Mailing Address - Phone:563-445-2273
Mailing Address - Fax:
Practice Address - Street 1:1807 EMERALD DR
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52804-3006
Practice Address - Country:US
Practice Address - Phone:563-445-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007066111N00000X
IA110733163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No163W00000XNursing Service ProvidersRegistered Nurse