Provider Demographics
NPI:1770571812
Name:FERRIS, JOANN (NP)
Entity type:Individual
Prefix:MS
First Name:JOANN
Middle Name:
Last Name:FERRIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5023 BRITTANIA CT
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-7826
Mailing Address - Country:US
Mailing Address - Phone:765-447-0385
Mailing Address - Fax:
Practice Address - Street 1:1321 UNITY PL
Practice Address - Street 2:SUITE A
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-5774
Practice Address - Country:US
Practice Address - Phone:765-446-2450
Practice Address - Fax:765-446-1083
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000096363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
INS01577Medicare UPIN