Individual
KASHAE FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
704 GOLD HILL RD, SUITE 107, FORT MILL, SC 29715-8906
(803) 835-0420
(704) 512-2231
Mailing address
PO BOX 602120, CHARLOTTE, NC 28260-2120
(803) 835-0420
(704) 512-2231
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19382
SC
363LF0000X
Family Nurse Practitioner
26NJ00487500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP3233
—
SC
Enumeration date
03/17/2014
Last updated
12/28/2015
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