Healthcare Provider Details

I. General information

NPI: 1205598364
Provider Name (Legal Business Name): FERGUSON NURSE CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2021
Last Update Date: 10/06/2021
Certification Date: 10/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19713 SORRENTO ST
DETROIT MI
48235-1149
US

IV. Provider business mailing address

19713 SORRENTO ST
DETROIT MI
48235-1149
US

V. Phone/Fax

Practice location:
  • Phone: 248-739-2290
  • Fax: 248-461-1229
Mailing address:
  • Phone: 248-739-2290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. DAMITA FERGUSON
Title or Position: CEO
Credential: RN, LNHA
Phone: 248-739-2290