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NPI Code Detail

MEDICARE: ALICE NICOLE FERGUSON

MEDICARE: ALICE NICOLE 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
1163WX0200XOncology Registered Nurse912764MS

General Provider Information

NPI Number : 1487586905
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICE NICOLE FERGUSON
Provider Business Mailing Address
First Line : 406 WOODLAKE CV W
Second Line :
City : BRANDON
State : MS
Zip : 39047-6093
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1227 N STATE ST STE 101
Second Line :
City : JACKSON
State : MS
Zip : 39202-2002
Country : US
Telephone Number : 601-355-2485
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “ ALICE NICOLE FERGUSON ” Practice Location

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