MEDICARE: MS. JENNIFER LEA FERGUSON M.D.

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
1	174400000X	Specialist	9700945	NC
2	207V00000X	Obstetrics & Gynecology Physician	9700945	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891757910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER LEA FERGUSON M.D.

Provider Business Mailing Address
First Line	:	2414 EMERALD PLACE
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-5784
Country	:	US
Telephone Number	:	252-355-7805
Fax Number	:	252-758-2970

Provider Business Practice Location Address
First Line	:	2414 EMERALD PLACE
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-5784
Country	:	US
Telephone Number	:	252-355-7805
Fax Number	:	252-758-2970

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2006
Last Update Date	:	01/09/2025

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