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MS. CANDACE ANNE FERGUSON NP

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1265449714

Individual Registrant:
MS. CANDACE ANNE FERGUSON NP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
129 KANSAS AVE  WALSENBURG, CO 81089-1818 US
Tel: 719-738-5200  Fax: 719-738-2732

Contact information for business:
129 KANSAS AVE  WALSENBURG, CO 81089-1818 US
Tel: 719-738-5200  Fax: 719-738-2732

Registration Information:
NPI: 1265449714
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
COAPN.0000488-NP

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
07602501CO05




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