Individual
KIMBERLY Y. FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
321C POPLAR DR, PETERSBURG, VA 23805-9306
(804) 733-5591
(804) 733-3506
Mailing address
321C POPLAR DR, PETERSBURG, VA 23805-9306
(804) 733-5591
(804) 733-3506
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110003173
VA
Other
Enumeration date
10/27/2009
Last updated
03/28/2018
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