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General NPI Number Information
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NPI Number | 1205640794
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Entity Type | Individual
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Provider Name | AMBER FERGUSON
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Gender | Female
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 2001 2ND AVE STE 201
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City | SUMMERVILLE
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State | SC
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Zip | 29486-7887
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Country | US
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Telephone | 843-572-4840
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 31665
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City | CHARLOTTE
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State | NC
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Zip | 28231-1665
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Country | US
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Telephone | 843-793-6980
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 29910
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License Number State | SC
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