Healthcare Provider Details

I. General information

NPI: 1285659326
Provider Name (Legal Business Name): NICOLE M FERGUSON AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 HEALTH PROFESSIONS BLDG
MT PLEASANT MI
48859-2827
US

IV. Provider business mailing address

2551 MCLEOD DR S
SAGINAW MI
48604-2827
US

V. Phone/Fax

Practice location:
  • Phone: 989-774-3904
  • Fax: 989-774-1891
Mailing address:
  • Phone: 989-799-8620
  • Fax: 989-799-2664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1601000164
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: