Individual
KELLY LYNN FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
2020 W STATE HIGHWAY 114 STE 200, GRAPEVINE, TX 76051-8648
(817) 912-8400
Mailing address
2020 W STATE HIGHWAY 114 STE 200, GRAPEVINE, TX 76051-8648
(817) 912-8400
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2022012572
TX
Other
Enumeration date
10/03/2022
Last updated
10/03/2022
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