Healthcare Provider Details

I. General information

NPI: 1629195961
Provider Name (Legal Business Name): NANCY J FERGUSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 ROAD ROUND THE LAKE
GRANTHAM NH
03753-1799
US

IV. Provider business mailing address

PO BOX 1799
GRANTHAM NH
03753-1799
US

V. Phone/Fax

Practice location:
  • Phone: 603-843-8913
  • Fax: 866-673-9513
Mailing address:
  • Phone: 603-843-8913
  • Fax: 866-673-9513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberMD437071
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number25MA04505700
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD437071
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number180258
License Number StateNH
# 5
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA04505700
License Number StateNJ
# 6
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number180258
License Number StateNH
# 7
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD437071
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: