Provider Demographics
NPI:1649152745
Name:FERRIS, JAMIE LYNN (BSN, RN, IBCLC)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LYNN
Last Name:FERRIS
Suffix:
Gender:F
Credentials:BSN, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1272 W MAIN RD BLDG 3
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-6335
Mailing Address - Country:US
Mailing Address - Phone:401-847-2290
Mailing Address - Fax:401-849-8446
Practice Address - Street 1:1272 W MAIN RD BLDG 3
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-6335
Practice Address - Country:US
Practice Address - Phone:401-847-2290
Practice Address - Fax:401-849-8446
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN77341163W00000X
MARN10000511163W00000X
RILLC00106163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse