Individual
JOLYN FERGON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P., C.N.M
Contact information
Practice address
1100 N PALM CANYON DR STE 212, PALM SPRINGS, CA 92262-4426
(760) 327-7900
(760) 327-7905
Mailing address
1100 N PALM CANYON DR STE 212, PALM SPRINGS, CA 92262-4426
(760) 327-7900
(760) 327-7905
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
NP10593
CA
367A00000X
Advanced Practice Midwife
1727
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0101240
—
CA
05
—
GR0101241
—
CA
05
—
GR0101242
—
CA
01
—
ZZZ27958Z
MEDICARE GROUP ID
CA
Enumeration date
08/29/2006
Last updated
06/19/2014
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