# MISS KELLY ELISE FERGUSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1497272892
- **Gender:** F
- **Credential:** MAC, LAC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | U02418 | MD | Yes |

## Other

- **Enumeration date:** 08/25/2017
- **Last updated:** 08/25/2017