Healthcare Provider Details

I. General information

NPI: 1437552635
Provider Name (Legal Business Name): JACQUELINE FERGUSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2014
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2194 ROMIG RD
AKRON OH
44320-3879
US

IV. Provider business mailing address

80 W STATE ST
BARBERTON OH
44203-1607
US

V. Phone/Fax

Practice location:
  • Phone: 234-340-9470
  • Fax:
Mailing address:
  • Phone: 234-340-9470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.467827
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: