Individual
MRS. JEAN TAYLOR FERGUSON
Active
Individual
MRS. JEAN TAYLOR FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9106099
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4598800
—
FL
Enumeration date
01/21/2011
Last updated
09/23/2013
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