MEDICARE: MISS CECELIA DENISE FERGUSON RN,BSN

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	RN47490	DC
2	163WN0300X	Nephrology Registered Nurse	RN47490	DC

General Provider Information

NPI Number	:	1811069594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CECELIA DENISE FERGUSON RN,BSN

Provider Business Mailing Address
First Line	:	11255 KETTERING PL
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-1578
Country	:	US
Telephone Number	:	301-728-4651
Fax Number	:	301-336-5349

Provider Business Practice Location Address
First Line	:	11255 KETTERING PL
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-1578
Country	:	US
Telephone Number	:	301-728-4651
Fax Number	:	301-336-5349

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

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	09/11/2025

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