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Individual

KIMBERLY R FERGUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1861 MAIN ST, SNEEDVILLE, TN 37869-3645
(423) 733-2131
(423) 733-1055
Mailing address
PO BOX 850, ROGERSVILLE, TN 37857-0850
(423) 272-9163
(423) 921-6920

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
104898
TN
363LF0000X
Family Nurse Practitioner
Primary
APN0000007174
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3902002
TN
Enumeration date
06/21/2005
Last updated
12/06/2010
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