Provider Demographics
NPI:1194570606
Name:FERGUSON, TONYA MICHELLE
Entity type:Individual
Prefix:MS
First Name:TONYA
Middle Name:MICHELLE
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 E SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:LOUISA
Mailing Address - State:KY
Mailing Address - Zip Code:41230-1036
Mailing Address - Country:US
Mailing Address - Phone:740-602-0217
Mailing Address - Fax:
Practice Address - Street 1:415 E SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:LOUISA
Practice Address - State:KY
Practice Address - Zip Code:41230-1036
Practice Address - Country:US
Practice Address - Phone:740-602-0217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker