Healthcare Provider Details

I. General information

NPI: 1427994482
Provider Name (Legal Business Name): AMBER PAIGE FERGUSON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2725 MALL OF GEORGIA BLVD FL 2
BUFORD GA
30519-8791
US

IV. Provider business mailing address

2760 CAMP BRANCH RD
BUFORD GA
30519-4455
US

V. Phone/Fax

Practice location:
  • Phone: 470-589-1237
  • Fax:
Mailing address:
  • Phone: 979-253-9184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP711490
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: