Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 3006668 | KY |
N | 363LA2100X | Nurse Practitioner - Acute Care | 0990672-NP | CO |
N | 363LA2100X | Nurse Practitioner - Acute Care | 3006668 | KY |
NPI | 1013227024 |
---|---|
Provider Name | Ms. Leslie Marie Ferguson |
First Address | Paducah, KY 42003-3813 |
Second Address | Paducah, KY 42003-3813 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2010 |
Last Update Date | 07/11/2016 |