Healthcare Provider Details

I. General information

NPI: 1487147633
Provider Name (Legal Business Name): HOPE ANN FERGUSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2018
Last Update Date: 01/19/2025
Certification Date: 01/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 E H ST
MC COOK NE
69001-3482
US

IV. Provider business mailing address

PO BOX 1207
MC COOK NE
69001-1207
US

V. Phone/Fax

Practice location:
  • Phone: 308-344-4110
  • Fax:
Mailing address:
  • Phone: 308-344-4110
  • Fax: 308-344-8369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number142-T1
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number33720
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: