1780965491 NPI number — MRS. SCHAUREN JADE FERRIS FNP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780965491 NPI number — MRS. SCHAUREN JADE FERRIS FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERRIS
Provider First Name:
SCHAUREN
Provider Middle Name:
JADE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HINSON
Provider Other First Name:
SCHAUREN
Provider Other Middle Name:
JADE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP-C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1780965491
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8001 DEVELOPMENT DR BLDG 8
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORRISVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27560-7416
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-237-8900
Provider Business Mailing Address Fax Number:
919-472-0601

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8001 DEVELOPMENT DR BLDG 8
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORRISVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27560-7416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-237-8900
Provider Business Practice Location Address Fax Number:
919-472-0601
Provider Enumeration Date:
09/08/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  5005327 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 6608040423 . This is a "PECOS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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