Individual
JOEL FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
1515 N MADISON AVE, ANDERSON, IN 46011-3453
(765) 298-5365
Mailing address
1515 N MADISON AVE, ANDERSON, IN 46011-3453
(765) 298-5365
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28185825A
IN
363LF0000X
Family Nurse Practitioner
Primary
71006136A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300002632
—
IN
Enumeration date
01/12/2016
Last updated
08/03/2017
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