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General NPI Number Information
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NPI Number | 1962959783
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Entity Type | Individual
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Provider Name | AMANDA FERGUSON APRN
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Gender | Female
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Dates
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Enumeration Date | 09/09/2016
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 3400 INDUSTRIAL LN UNIT 1A
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City | BROOMFIELD
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State | CO
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Zip | 80020-1650
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Country | US
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Telephone | 720-912-4098
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Fax |
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Provider Business Mailing Address
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Address Line | 1323 S ELMORO CT
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City | SUPERIOR
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State | CO
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Zip | 80027-8068
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Country | US
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Telephone | 402-916-0215
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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 | APN.0994342-NP
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License Number State | CO
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