| NPI | 1629246574 | 
|---|---|
| Former Name | CHARLSIE ELIZABETH FERGUSON / PHILLIPS | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP116578) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP116578) | 
| 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP116578) | |
| Enumeration Date | 2008-02-13 | 
| Last Update Date | 2025-07-17 |