Individual
MRS. REBECCA BREWER FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2011 TATE SPRINGS RD, LYNCHBURG, VA 24501-1111
(434) 947-3963
(434) 947-5935
Mailing address
5457 VILLAGE HWY, LYNCHBURG, VA 24504-5387
(434) 485-6101
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110-005956
VA
363A00000X
Physician Assistant
0110005956
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033629050
—
VA
Enumeration date
10/04/2017
Last updated
03/10/2021
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