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Individual

CRYSTAL J FERGUSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPM

Contact information

Practice address
3450 S CAMPBELL AVE, SPRINGFIELD, MO 65807-5102
(417) 616-3212
Mailing address
2320 N ROGERS AVE, SPRINGFIELD, MO 65803-4158
(417) 616-3212

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18070011
CPM CERTIFICATION NUMBER
Enumeration date
07/09/2018
Last updated
07/09/2018
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