MEDICARE: NAARA FERGUSON RN

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	163W00000X	Registered Nurse	9577339	FL

General Provider Information

NPI Number	:	1952233926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAARA FERGUSON RN

Provider Business Mailing Address
First Line	:	119 SUNRISE VISTA WAY
Second Line	:
City	:	PONTE VEDRA
State	:	FL
Zip	:	32081-0143
Country	:	US
Telephone Number	:	210-912-2533
Fax Number	:

Provider Business Practice Location Address
First Line	:	119 SUNRISE VISTA WAY
Second Line	:
City	:	PONTE VEDRA
State	:	FL
Zip	:	32081-0143
Country	:	US
Telephone Number	:	210-912-2533
Fax Number	:

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

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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