1053184648 NPI number — DR. CHELSEA LEAH FERGUSON DNP, FNP-C

Table of content: DR. CHELSEA LEAH FERGUSON DNP, FNP-C (NPI 1053184648)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053184648 NPI number — DR. CHELSEA LEAH FERGUSON DNP, FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERGUSON
Provider First Name:
CHELSEA
Provider Middle Name:
LEAH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DNP, FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053184648
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/13/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
901 DOW RD N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAROLINA BEACH
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28428-4141
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
866-389-2727
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
319 VILLAGE RD NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LELAND
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28451-7417
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-721-1197
Provider Business Practice Location Address Fax Number:
910-721-1199
Provider Enumeration Date:
11/06/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  5019109 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com