Provider Demographics
NPI:1649866567
Name:FERRELL, DEBRA SAUNDERS
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:SAUNDERS
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 1:501 BELL DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-4913
Mailing Address - Country:US
Mailing Address - Phone:434-728-2769
Mailing Address - Fax:
Practice Address - Street 1:204 HUGHES ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-3941
Practice Address - Country:US
Practice Address - Phone:434-728-2769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA35357622010Medicaid