Individual
CHANTE NICOLE FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
403 PINE ST, TAYLORSVILLE, MS 39168-5659
(601) 452-7080
(601) 452-7083
Mailing address
403 PINE ST, TAYLORSVILLE, MS 39168-5659
(601) 452-7080
(601) 452-7083
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
894623
MS
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
08/17/2020
Last updated
11/30/2021
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