Individual
TRACEY A FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
911 N GEYER RD, KIRKWOOD, MO 63122-2626
(985) 445-7887
(866) 239-3913
Mailing address
911 N GEYER RD, KIRKWOOD, MO 63122-2626
(985) 445-7887
(866) 239-3913
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
79318
LA
Other
Enumeration date
06/03/2016
Last updated
06/03/2016
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