Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | SP008851 | PA |
N | 363LC1500X | Nurse Practitioner - Community Health | SP008851 | PA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | SP008851 | PA |
NPI | 1730197484 |
---|---|
Provider Name | Linda M. Ferguson |
First Address | Philadelphia, PA 19107-4824 |
Second Address | Philadelphia, PA 19107-4824 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 28/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102866705 | (05) | PA |