Individual
KELLY LINETTE FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
401 N MAIN ST, KENANSVILLE, NC 28349-8801
(910) 296-0941
Mailing address
401 N MAIN ST, KENANSVILLE, NC 28349-8801
(910) 296-0941
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
2017-01138
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/05/2013
Last updated
08/02/2022
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