Provider Demographics
NPI:1013155076
Name:FERKO, JEFFREY ANDREW (CRNA)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ANDREW
Last Name:FERKO
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 MEADOW AVE
Mailing Address - Street 2:
Mailing Address - City:CENTRAL CITY
Mailing Address - State:PA
Mailing Address - Zip Code:15926-1243
Mailing Address - Country:US
Mailing Address - Phone:814-754-4006
Mailing Address - Fax:
Practice Address - Street 1:136 MEADOW AVE
Practice Address - Street 2:
Practice Address - City:CENTRAL CITY
Practice Address - State:PA
Practice Address - Zip Code:15926-1243
Practice Address - Country:US
Practice Address - Phone:814-754-4006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-29
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN535359367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered