Healthcare Provider Details

I. General information

NPI: 1972831881
Provider Name (Legal Business Name): CHRISTOPHER K FERGUSON CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2009
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 VILLAGE WAY STE 2B
HUDSON OH
44236-5127
US

IV. Provider business mailing address

7659 ROEPER RD
PARMA OH
44134-6177
US

V. Phone/Fax

Practice location:
  • Phone: 330-656-5215
  • Fax:
Mailing address:
  • Phone: 330-401-7809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberAPRN.CRNA.11259
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN317731
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: