Provider Demographics
NPI:1104878529
Name:FERRELL, MARIA A (APRN, BC-PCM)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:A
Last Name:FERRELL
Suffix:
Gender:F
Credentials:APRN, BC-PCM
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:A
Other - Last Name:KIRCHHOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, BC-PCM
Mailing Address - Street 1:9001 STATE LINE RD # 300
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-3232
Mailing Address - Country:US
Mailing Address - Phone:816-363-2600
Mailing Address - Fax:816-523-0068
Practice Address - Street 1:9001 STATE LINE RD # 300
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-3232
Practice Address - Country:US
Practice Address - Phone:816-363-2600
Practice Address - Fax:816-523-0068
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-76688363LA2200X
MO2014039089363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q66120Medicare UPIN