Individual
BONNY F. FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
9263 MEDICAL PLAZA DR., STE E, CHARLESTON, SC 29406-7112
(843) 572-1228
(877) 561-7564
Mailing address
9263 MEDICAL PLAZA DR., STE E, CHARLESTON, SC 29406-7112
(843) 572-1228
(877) 561-7564
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
78227
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
17689
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN2186
—
SC
Enumeration date
11/09/2011
Last updated
06/01/2012
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