Provider Demographics
NPI:1053410738
Name:FERGUSON, PENELOPE E (RD)
Entity type:Individual
Prefix:MS
First Name:PENELOPE
Middle Name:E
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3369 PRESTON SHORE DR
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-4919
Mailing Address - Country:US
Mailing Address - Phone:540-908-6640
Mailing Address - Fax:
Practice Address - Street 1:3369 PRESTON SHORE DR
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-4919
Practice Address - Country:US
Practice Address - Phone:540-908-6640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered