Provider Demographics
NPI:1588559231
Name:FERRELL, KATIANNE PELLEY (ACNPC-AG)
Entity type:Individual
Prefix:
First Name:KATIANNE
Middle Name:PELLEY
Last Name:FERRELL
Suffix:
Gender:F
Credentials:ACNPC-AG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 KENDALL RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71292-0189
Mailing Address - Country:US
Mailing Address - Phone:318-547-1585
Mailing Address - Fax:318-966-1212
Practice Address - Street 1:101 CATALPA ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7418
Practice Address - Country:US
Practice Address - Phone:318-998-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA241507363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care