Individual
JENNIFER COUSINS FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 FERNDALE BLVD, HIGH POINT, NC 27262-4739
(336) 882-2567
(336) 882-5466
Mailing address
PO BOX 2168, HIGH POINT, NC 27261-2168
(336) 882-2567
(336) 882-5466
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
158999
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
081864
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8053306
—
NC
Enumeration date
08/04/2008
Last updated
10/27/2020
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