Individual
KIMBERLY ANN FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1103 S GRAYCROFT AVE, MADISON, TN 37115-4427
(615) 406-5520
Mailing address
1103 S GRAYCROFT AVE, MADISON, TN 37115-4427
(615) 406-5520
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
OTA0000000280
TX
Other
Enumeration date
04/13/2011
Last updated
04/13/2011
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