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Individual

KAITLYN FERGUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2315 MYRTLE ST STE L90, ERIE, PA 16502-4607
(814) 452-7575
Mailing address
2315 MYRTLE ST STE L90, ERIE, PA 16502-4607
(814) 452-7575

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA058740
PA

Other

Enumeration date
10/09/2014
Last updated
09/30/2020
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