Provider Demographics
NPI:1699338129
Name:FERRELL, JAPONICA NIKKITTA
Entity type:Individual
Prefix:
First Name:JAPONICA
Middle Name:NIKKITTA
Last Name:FERRELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11703 SWEET SERENITY LN UNIT 204
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-4565
Mailing Address - Country:US
Mailing Address - Phone:863-308-6685
Mailing Address - Fax:
Practice Address - Street 1:11703 SWEET SERENITY LN UNIT 204
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-4565
Practice Address - Country:US
Practice Address - Phone:863-308-6685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2019-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN273705163WH0200X, 163WC1500X, 163WL0100X
FLRN9472248163WI0600X, 163WS0200X, 163WX0002X, 163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WS0200XNursing Service ProvidersRegistered NurseSchool
No163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk