Individual
BREANA JANE FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
3415 MACCORKLE AVE SE, CHARLESTON, WV 25304-1334
(304) 388-5432
Mailing address
329 EUREKA RD, CHARLESTON, WV 25314-2151
(507) 273-7376
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
112631
WV
Other
Enumeration date
02/02/2023
Last updated
02/02/2023
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