Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 1003248576 | CA |
N | 363LA2200X | Nurse Practitioner - Adult Health | 2013001175 | MN |
NPI | 1003248576 |
---|---|
Provider Name | Ms. Merissa Anne Ferraro |
First Address | San Diego, CA 92121-4250 |
Second Address | San Diego, CA 92121-4250 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2013 |
Last Update Date | 06/05/2019 |