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General NPI Number Information
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NPI Number | 1023066057
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Entity Type | Individual
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Provider Name | TAMMI L FERGUSON FNP
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Gender | Female
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 01/26/2021
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Provider Practice Location Address
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Address Line | 1700 W MARKET ST SUITE J
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City | BOLIVAR
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State | TN
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Zip | 38008-1653
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Country | US
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Telephone | 731-652-5772
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Fax | 731-658-1981
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Provider Business Mailing Address
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Address Line | 116 W MAIN ST
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City | HENDERSON
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State | TN
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Zip | 38340-2231
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Country | US
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Telephone | 731-989-0001
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Fax | 731-989-5151
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN6811
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License Number State | TN
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