Provider Demographics
NPI:1194522144
Name:FERRELL, TAMMY RUTH (APRN, FNP)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:RUTH
Last Name:FERRELL
Suffix:
Gender:
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6010 CLEARWATER DR
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70460-3918
Mailing Address - Country:US
Mailing Address - Phone:601-530-3201
Mailing Address - Fax:
Practice Address - Street 1:200 GOLF COURSE DR
Practice Address - Street 2:
Practice Address - City:CARRIERE
Practice Address - State:MS
Practice Address - Zip Code:39426-9037
Practice Address - Country:US
Practice Address - Phone:601-699-9846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS907260363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care