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General NPI Number Information
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NPI Number | 1083306146
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Entity Type | Individual
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Provider Name | TANYA L. FERGUSON APRN
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Gender | Female
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Dates
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Enumeration Date | 05/25/2023
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 2002 S VIRGINIA ST
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-3612
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Country | US
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Telephone | 270-874-2026
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Fax |
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Provider Business Mailing Address
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Address Line | 2002 S VIRGINIA ST
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-3612
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Country | US
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Telephone | 270-874-2026
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Fax |
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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 | 4000409
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License Number State | KY
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