NPI 1013208842

Nicole Ferguson, MA

Practitioner Specialist Phoenix, AZ

Practice location

Address: 2925 E Blackhawk Dr, Phoenix, AZ 85050-4721
Phone: (480) 221-7264

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 3998362 (AZ)

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Registry record

NPI: 1013208842
Entity type: Individual
Sex (as registered): Female
NPI issued: 27 Apr 2011
Record last updated: 27 Apr 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.