Provider Demographics
NPI:1548848583
Name:FERRARO, SHANNON EILEEN (FNP-C, ARNP)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:EILEEN
Last Name:FERRARO
Suffix:
Gender:F
Credentials:FNP-C, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2116 BOBBYBER DR
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-4025
Mailing Address - Country:US
Mailing Address - Phone:857-204-8833
Mailing Address - Fax:
Practice Address - Street 1:3975 FAIR RIDGE DR STE 125
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-2911
Practice Address - Country:US
Practice Address - Phone:703-259-8423
Practice Address - Fax:703-259-8424
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11018152363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily