Provider Demographics
NPI:1306331897
Name:FERGUSON, ANGELINA SASSO (APRN-BC, FNP)
Entity type:Individual
Prefix:
First Name:ANGELINA
Middle Name:SASSO
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:APRN-BC, FNP
Other - Prefix:
Other - First Name:ANGELINA
Other - Middle Name:MARIE
Other - Last Name:SASSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1089
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70404-1089
Mailing Address - Country:US
Mailing Address - Phone:985-892-7070
Mailing Address - Fax:985-892-7017
Practice Address - Street 1:1310 GAUSE BLVD
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-3016
Practice Address - Country:US
Practice Address - Phone:985-602-1215
Practice Address - Fax:985-259-4505
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-27
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP10082363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily