MEDICARE: JACQUELINE FERGUSON RN

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
1	163W00000X	Registered Nurse	RN.467827	OH

General Provider Information

NPI Number	:	1437552635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE FERGUSON RN

Provider Business Mailing Address
First Line	:	80 W STATE ST
Second Line	:
City	:	BARBERTON
State	:	OH
Zip	:	44203-1607
Country	:	US
Telephone Number	:	234-340-9470
Fax Number	:

Provider Business Practice Location Address
First Line	:	2194 ROMIG RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44320-3879
Country	:	US
Telephone Number	:	234-340-9470
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2014
Last Update Date	:	04/16/2026

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