Provider Demographics
NPI:1053403493
Name:FERGUSON, DEBBIE ANN (FNP)
Entity type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:ANN
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:104 SHERWOOD CT
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093-1632
Mailing Address - Country:US
Mailing Address - Phone:478-929-8990
Mailing Address - Fax:478-929-8990
Practice Address - Street 1:5398 THOMASTON RD STE B
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31220-8110
Practice Address - Country:US
Practice Address - Phone:478-476-8868
Practice Address - Fax:478-476-8161
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN106333363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily