Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 86036 | NC |
NPI | 1023079308 |
---|---|
Provider Name | Ms. Cynthia Ferguson |
First Address | High Point, NC 27262-7008 |
Second Address | High Point, NC 27265-3170 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2006 |
Last Update Date | 05/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00655181 | RR MEDICARE (01) | NC |
P18015 | (02) | NC |