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Individual
LISA FERGUSON
Active
Individual
LISA FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP126466
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
341244701
—
TX
01
—
75-2616977-028
TRICARE
TX
01
—
8759NL
BCBS
TX
01
—
P01408022
RAILROAD MEDICARE
TX
Enumeration date
09/30/2014
Last updated
03/05/2015
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