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NPI Code Detail

MEDICARE: LAURA ANN FERGUSON CRNA

MEDICARE: LAURA ANN FERGUSON CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistR084287AR

General Provider Information

NPI Number : 1083051312
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA ANN FERGUSON CRNA
Provider Business Mailing Address
First Line : 4298 DENA JO
Second Line : APT 160
City : JONESBORO
State : AR
Zip : 72404-7888
Country : US
Telephone Number : 870-530-0159
Fax Number : 501-227-0744
Provider Business Practice Location Address
First Line : 2024 ARKANSAS VALLEY DR
Second Line : #202
City : LITTLE ROCK
State : AR
Zip : 72212-4166
Country : US
Telephone Number : 501-227-0700
Fax Number : 501-227-0744
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2013
Last Update Date : 05/28/2013

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Directions to “ LAURA ANN FERGUSON CRNA” Practice Location

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