Basic Information
| Provider Information | |||||||||
| NPI: | 1346270469 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FERRARI | ||||||||
| FirstName: | PATRICIA | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5525 RESEARCH PARK DR | ||||||||
| Address2: | 4TH FLOOR | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212284873 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7039234644 | ||||||||
| FaxNumber: | 7039234625 | ||||||||
| Practice Location | |||||||||
| Address1: | 7440 SPRING VILLAGE DR | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221504446 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7039234644 | ||||||||
| FaxNumber: | 7039234625 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2006 | ||||||||
| LastUpdateDate: | 05/06/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SP0808X | 001-5000119 | VA | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psych/Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 8304078 | 01 | EVERCARE | OTHER | 541908787 | 01 | TRICARE | OTHER | 60708801 | 01 | MD | BCBS OF MD | OTHER | (5) | 05 | VA | MEDICAID | PV230681 | 01 | APS HEALTHCARE | OTHER | 0004 | 01 | CAREFIRST | OTHER |