Individual
SIERRA FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9300 E 29TH ST N STE 206, WICHITA, KS 67226-2183
(316) 260-6762
(316) 260-6763
Mailing address
9300 E 29TH ST N STE 206, WICHITA, KS 67226-2183
(316) 260-6762
(316) 260-6763
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-01554
KS
363A00000X
Physician Assistant
T-03430
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200966590B
—
KS
Enumeration date
08/29/2012
Last updated
06/15/2021
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