MEDICARE: CHRISTOPHER K FERGUSON CRNA

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	367500000X	Certified Registered Nurse Anesthetist	RN317731	OH
2	207L00000X	Anesthesiology Physician	APRN.CRNA.11259	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01103219	OTHER	OH	MEDICARE RAILROAD

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	:	1972831881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER K FERGUSON CRNA

Provider Business Mailing Address
First Line	:	7659 ROEPER RD
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44134-6177
Country	:	US
Telephone Number	:	330-401-7809
Fax Number	:

Provider Business Practice Location Address
First Line	:	72 VILLAGE WAY STE 2B
Second Line	:
City	:	HUDSON
State	:	OH
Zip	:	44236-5127
Country	:	US
Telephone Number	:	330-656-5215
Fax Number	:

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

Provider Enumeration Date	:	12/04/2009
Last Update Date	:	09/26/2019

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Directions to “ CHRISTOPHER K FERGUSON CRNA” Practice Location

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