Individual
MRS. JENNIFFER SUE FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
601 E DIXIE AVE, PLAZA 901, LEESBURG, FL 34748-5998
(352) 728-2404
(352) 787-7401
Mailing address
601 E DIXIE AVE, PLAZA 901, LEESBURG, FL 34748-5998
(352) 728-2404
(352) 787-7401
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9103323
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292263100
—
FL
Enumeration date
07/21/2006
Last updated
08/23/2010
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