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NPI Code Detail

MEDICARE: PEGGY LEE FERGUSON CRNP

MEDICARE: PEGGY LEE FERGUSON CRNP
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
1363LF0000XFamily Nurse Practitioner34114WV

General Provider Information

NPI Number : 1770749913
Entity Type Code : Individual
Provider Name (Legal Business Name) : PEGGY LEE FERGUSON CRNP
Provider Business Mailing Address
First Line : 215 DON KNOTTS BLVD
Second Line : SUITE 130
City : MORGANTOWN
State : WV
Zip : 26501-6734
Country : US
Telephone Number : 304-291-3627
Fax Number : 304-284-8667
Provider Business Practice Location Address
First Line : 215 DON KNOTTS BLVD
Second Line : SUITE 130
City : MORGANTOWN
State : WV
Zip : 26501-6734
Country : US
Telephone Number : 304-291-3627
Fax Number : 304-284-8667
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2008
Last Update Date : 08/06/2008

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Directions to “ PEGGY LEE FERGUSON CRNP” Practice Location

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