| NPI | 1639648355 |
|---|---|
| Former Name | SHANA FERGUSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11035678) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704272887) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704272887) | |
| Enumeration Date | 2018-11-26 |
| Last Update Date | 2025-05-27 |