Individual
LISA MARIE FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
7101 FAIRWAY DR, PALM BEACH GARDENS, FL 33418-3701
(561) 515-1500
Mailing address
7101 FAIRWAY DR, PALM BEACH GARDENS, FL 33418-3701
(561) 515-1500
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9167524
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
307786100
—
FL
01
—
G4065
BCBS OF FLORIDA
FL
Enumeration date
07/08/2006
Last updated
03/29/2018
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