Provider Demographics
NPI:1548348865
Name:FERRIELL, CHRISTIE (RD, CD)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:
Last Name:FERRIELL
Suffix:
Gender:F
Credentials:RD, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 REID PKWY
Mailing Address - Street 2:MEDICAL STAFF SERVICES
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-1157
Mailing Address - Country:US
Mailing Address - Phone:765-983-3293
Mailing Address - Fax:765-983-3219
Practice Address - Street 1:1050 REID PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1155
Practice Address - Country:US
Practice Address - Phone:765-935-8941
Practice Address - Fax:765-935-8578
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37001604A133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN85007106OtherCDR# REID HOSPITAL
IN000000943469OtherANTHEM
IN259370061Medicare PIN