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Individual
MRS. TIFFANY FERGUSON
Active
Individual
MRS. TIFFANY FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041358468
IL
363LF0000X
Family Nurse Practitioner
209013649
IL
363LF0000X
Family Nurse Practitioner
Primary
277000224
IL
Other
Enumeration date
10/28/2015
Last updated
09/12/2023
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