Provider Demographics
NPI:1568281806
Name:FERRALL, ELIZABETH (IBCLC, RD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:FERRALL
Suffix:
Gender:F
Credentials:IBCLC, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 17 MILE RD
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-9797
Mailing Address - Country:US
Mailing Address - Phone:269-697-1088
Mailing Address - Fax:
Practice Address - Street 1:10200 17 MILE RD
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-9797
Practice Address - Country:US
Practice Address - Phone:269-697-1088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN