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General NPI Number Information
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NPI Number | 1235779075
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Entity Type | Individual
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Provider Name | LINDSEY M FERGUSON
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Gender | Female
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Dates
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Enumeration Date | 01/09/2020
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Last Update Date | 01/09/2020
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Provider Practice Location Address
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Address Line | 2475 VENTURA BLVD
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City | CAMARILLO
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State | CA
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Zip | 93010-6650
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Country | US
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Telephone | 805-991-0202
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Fax |
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Provider Business Mailing Address
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Address Line | 10508 SAN BRUNO ST
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City | VENTURA
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State | CA
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Zip | 93004-2996
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Country | US
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Telephone |
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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 | 95013465
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License Number State | CA
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