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General NPI Number Information
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NPI Number | 1659476505
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Entity Type | Individual
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Provider Name | PHYLLIS A FERGUSON ARNP
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Gender | Female
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 9416 271ST ST NW
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City | STANWOOD
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State | WA
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Zip | 98292-8094
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Country | US
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Telephone | 425-820-2440
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2718
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City | STANWOOD
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State | WA
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Zip | 98292-2718
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Country | US
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Telephone | 425-820-2440
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Fax | 425-820-8616
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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 | AP3001680
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP3001680
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License Number State | WA
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