Provider Demographics
NPI:1982249223
Name:FERRY, BROOK MICHELLE (FNP BC-C)
Entity type:Individual
Prefix:
First Name:BROOK
Middle Name:MICHELLE
Last Name:FERRY
Suffix:
Gender:F
Credentials:FNP BC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 APPLETON DR
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-2502
Mailing Address - Country:US
Mailing Address - Phone:609-510-9676
Mailing Address - Fax:
Practice Address - Street 1:5 APPLETON DR
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08610-2501
Practice Address - Country:US
Practice Address - Phone:609-510-9676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-11
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00983200363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily