Healthcare Provider Details

I. General information

NPI: 1386987543
Provider Name (Legal Business Name): REBEKAH FERGUSON DUKE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2013
Last Update Date: 04/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 S ACADEMY BLVD
COLORADO SPRINGS CO
80916-3004
US

IV. Provider business mailing address

2728 GOLDEN CURRANT VW APT 105
COLORADO SPRINGS CO
80918-9066
US

V. Phone/Fax

Practice location:
  • Phone: 719-393-9688
  • Fax: 719-393-9627
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19349
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: