Healthcare Provider Details

I. General information

NPI: 1568287175
Provider Name (Legal Business Name): EMILY ANN MASON-FERGUSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13265 TOWNSHIP ROAD 59
MOUNT PERRY OH
43760-9743
US

IV. Provider business mailing address

6795 CIMARRON RD
MOUNT PERRY OH
43760-9664
US

V. Phone/Fax

Practice location:
  • Phone: 740-328-9260
  • Fax:
Mailing address:
  • Phone: 740-348-6550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: