Individual
NICOLE L FERGUSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSING
Contact information
Practice address
550 W 700 S, SALT LAKE CITY, UT 84101-2227
(801) 531-1857
Mailing address
609 WILSON AVE, SALT LAKE CITY, UT 84105-3007
(801) 467-4056
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
2222843102
UT
Other
Enumeration date
06/13/2007
Last updated
07/08/2007
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