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NPI Code Detail

MEDICARE: CHRISTEN FERGUSON

MEDICARE: CHRISTEN FERGUSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183700000XPharmacy TechnicianPT00029868KY

General Provider Information

NPI Number : 1104217116
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTEN FERGUSON
Provider Business Mailing Address
First Line : 4640 TAYLORSVILLE RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40220-3530
Country : US
Telephone Number : 502-493-2732
Fax Number :
Provider Business Practice Location Address
First Line : 4640 TAYLORSVILLE RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40220-3530
Country : US
Telephone Number : 502-493-2732
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2015
Last Update Date : 02/12/2015

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Directions to “ CHRISTEN FERGUSON ” Practice Location

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