Individual
MS. KELLI ENSLEY FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA II
Contact information
Practice address
2825 RANDOLPH RD, CHARLOTTE, NC 28211-1018
(704) 377-1647
Mailing address
108 BLAIR LN APT B, BESSEMER CITY, NC 28016-9300
(704) 913-8715
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
71763
NC
Other
Enumeration date
03/27/2020
Last updated
03/27/2020
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